Attorneys challenge Ohio abortion laws

IN THE COURT OF COMMON PLEAS
HAMILTON COUNTY, OHIO
PLANNED PARENTHOOD
SOUTHWEST OHIO REGION, et al.,
Case No. A 2101148
Plaintiffs,
Judge Alison Hatheway
v.
PLAINTIFFS’ MOTION FOR LEAVE
OHIO DEPARTMENT OF HEALTH, et al., TO FILE AMENDED COMPLAINT
Defendants.
Pursuant to Ohio Civil Rule 15(A), Planned Parenthood Southwest Ohio Region, Sharon
Liner, M.D., and Planned Parenthood of Greater Ohio (collectively, “Plaintiffs”), by and through
their undersigned counsel, hereby move this Honorable Court for leave to file an Amended
Complaint (attached hereto as Exhibit 1), to add new parties and assert additional claims under the
newly enacted Article I, Section 22 of the Ohio Constitution (the “Motion”). Ohio voters’ recent
approval of “The Right to Reproductive Freedom with Protections for Health and Safety”
constitutional amendment (the “Amendment”), effective as of December 7, 2023, as Article I,
Section 22 of the Ohio Constitution (attached hereto as Exhibit 2), establishes the “right to make
and carry out one’s own reproductive decisions,” including the decision to have an abortion. Ohio
Constitution, Article I, Section 22(A). The Amendment further mandates that the State “shall not,
directly or indirectly, burden, penalize, prohibit, interfere with, or discriminate against” either: (1)
“[a]n individual’s voluntary exercise of this right,” or (2) “[a] person or entity that assists an
individual exercising this right,” unless the State can show that it is using the least restrictive means
to advance patient health in accordance with widely accepted and evidence-based standards of
care. Ohio Constitution, Article I, Section 22(B). The Amendment therefore creates a new cause
of action that applies directly to the challenged law, R.C. 2919.124 (the “Telemedicine Ban”),
further rendering it unconstitutional. Accordingly, through this Motion, Plaintiffs seek leave to
amend their Complaint to challenge the Telemedicine Ban as unconstitutional under the
Amendment.
Plaintiffs also seek to amend their Complaint to challenge two additional restrictions on
medication abortion that, like the Telemedicine Ban, are unconstitutional under the Amendment’s
protections: (1) a series of laws that together prohibit qualified and skilled health care providers
known as advanced practice clinicians (“APCs”) from providing medication abortion, regardless
of their education, training, and experience, R.C. 2317.56(B), 2919.123, 4723.44(B)(6),
4723.50(B)(1), 4723.151(C), 4730.02(E), 4730.03(F), 4730.39(B)(2), 4730.42(A)(1); Ohio
Adm.Code 4723-9-10(K), 4730-2-07(E) (the “APC Ban”); and (2) a ban on prescribing
mifepristone for abortion in any way that differs from the formulation set forth in the U.S. Food
and Drug Administration’s (“FDA”) label for the drug, including in otherwise safe, widely-
accepted, and evidence-based “off-label” formulations, R.C. 2919.123 (the “Evidence-Based Use
Ban,” and together with the Telemedicine and APC Bans, the “Challenged Laws”). As a result of
these additional challenges, Plaintiffs also seek to add certain plaintiffs and defendants and to
provide additional allegations supporting their claims for relief. Because Plaintiffs make this
request in good faith and have not unduly delayed this request, and because there will be no
prejudice to Defendants, leave to amend should be granted.
MEMORANDUM IN SUPPORT
In the present action, this Court is tasked with determining whether restrictions on the
provision of medication abortion violate the Ohio Constitution. Ohio voters recently approved the
Amendment, which explicitly protects the right to abortion and lays out a new framework for
determining the constitutionality of abortion restrictions. Allowing Plaintiffs to amend their
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Complaint to bring claims under the Amendment and challenge additional medication abortion
restrictions in light of this new legal development is necessary in the interest of justice.
I. PROCEDURAL BACKGROUND
Plaintiffs originally brought this action before this Court in April 2021. In the original
Complaint, Plaintiffs asserted claims for violations of the Ohio Constitution’s equal protection and
benefit guarantee under Article I, Section 2, and the Ohio Constitution’s protections for individual
liberty under Article I, Sections 1, 2, 16, 20, and 21. Plaintiffs further sought a temporary
restraining order followed by a preliminary injunction, a declaratory judgment, and permanent
injunctive relief, against the Telemedicine Ban.
On April 7, 2021, this Court issued a temporary restraining order. Following an expedited
briefing schedule and oral argument, the Court issued a preliminary injunction enjoining
enforcement of the Telemedicine Ban, finding that absent relief, Ohioans would have suffered
irreparable deprivation of their constitutional rights and serious, irreparable harm to their physical,
psychological, and emotional well-being. That preliminary injunction is still in effect.
On July 13, 2022, the Court granted Plaintiffs’ Motion to Stay Proceedings pending
resolution of State ex rel. Preterm-Cleveland v. Yost, No. 2022-0803 (Ohio June 20, 2022).
Since this Court’s grant of Plaintiffs’ Motion to Stay, the people of Ohio voted to amend
the Ohio Constitution to explicitly protect the right to abortion. See Ohio Constitution, Article I,
Section 22. On December 15, 2023, after the Amendment took effect, the Ohio Supreme Court
dismissed the appeal in State ex rel. Preterm-Cleveland. See State ex rel. Preterm-Cleveland v.
Yost, No. 2023-0004 (Ohio Dec. 15, 2023). This Court thereafter lifted the stay in this case.
At this stage in the litigation, Plaintiffs may only amend the complaint with Defendants’
written consent or by leave of this Court. See Civ.R. 15(A). On May 8, 2024, Plaintiffs sought
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Defendants’ written consent; Plaintiffs did not receive a response indicating whether Defendants
consent. Accordingly, Plaintiffs move this Court for leave to amend their Complaint.
II. LAW AND ANALYSIS
Ohio Civil Rule 15(A) provides that courts “shall freely give leave” to amend pleadings
“when justice so requires.” “The language of Civ.R. 15(A) favors a liberal amendment policy and
a motion for leave to amend should be granted absent a finding of bad faith, undue delay or undue
prejudice to the opposing party.” Hoover v. Sumlin, 12 Ohio St.3d 1, 6, 465 N.E.2d 377 (1984);
see also Darby v. A-Best Prods. Co., 102 Ohio St.3d 410, 2004-Ohio-3720, 811 N.E.2d 1117, ¶ 20;
Wilmington Steel Prods., Inc. v. Cleveland Elec. Illuminating Co., 60 Ohio St.3d 120, 122, 573
N.E.2d 622 (1991). In ruling on a motion for leave to amend, courts consider multiple factors,
including “whether the movant made a prima facie showing of support for the new matters sought
to be pleaded, the timeliness of the motion, and whether the proposed amendment would prejudice
the opposing party.” Danopulos v. Am. Trading II, LLC, 2016-Ohio-5014, 69 N.E.3d 157, ¶ 24
(1st Dist.). Here, Plaintiffs’ Motion is meritorious, timely, and would result in no undue prejudice
to Defendants, and thus should be granted in the interest of justice.
This Motion is necessary in light of a major legal development: the adoption of a new
amendment to the Ohio Constitution that establishes a clear and unequivocal right to abortion. See
Ohio Constitution, Article I, Section 22(A). After Plaintiffs filed their Complaint, a citizen-led
effort to amend the Ohio Constitution resulted in the Reproductive Freedom Amendment
appearing as Issue 1 on the November 2023 General Election ballot. On November 7, 2023,
Ohioans voted to approve Issue 1, adopting the Amendment as Article I, Section 22 of the Ohio
Constitution, effective on December 7, 2023. See Ohio Secretary of State, 2023 Official Election
4
Results, General Election: November 7, 2023, available at
https://www.sos.state.oh.us/elections/election-results-and-data/2023-official-election-results/.
The Amendment provides more than prima facie support for the merits of Plaintiffs’ claims
that the Challenged Laws are unconstitutional. Under the Amendment, the State may not “directly
or indirectly, burden, penalize, prohibit, interfere with, or discriminate against either[] [a]n
individual’s voluntary exercise of th[e] right [to abortion] or [a] person or entity that assists an
individual exercising this right” prior to the point of fetal viability, “unless the State demonstrates
that it is using the least restrictive means to advance the individual’s health in accordance with
widely accepted and evidence-based standards of care.” Ohio Constitution, Article I, Section
22(B). The Challenged Laws violate Ohio Constitution, Article I, Section 22(A) for the following
reasons.
First, the Telemedicine Ban prohibits abortion providers from providing medication
abortion to Ohioans through telemedicine and thus restricts access to abortion. See Senate Bill
No. 260, 2020 Ohio Laws File 113 (adding R.C. 2919.124) (“SB 260”). Providers who violate the
Telemedicine Ban face felony criminal penalties and civil and professional sanctions.
Telemedicine medication abortion (“TMAB”) has been studied extensively and determined to be
safe and effective, preferred by many patients, and critical to expanding abortion access to
underserved areas and reducing travel and related burdens on patients. Although currently
enjoined, if the Telemedicine Ban were permitted to go into effect, it would substantially increase
the distances that many patients must travel to obtain medication abortions, which in turn would
delay and impede access to abortion, risking harm to Ohioans’ health and well-being.
Second, the APC Ban restricts qualified and skilled APCs from providing medication
abortion, regardless of their education, training, and experience, even though this is within their
5
scope of practice, and Ohio permits them to prescribe the exact same medications for other
purposes. See R.C. 2317.56(B), 2919.11, 2919.123, 4723.44(B)(6), 4723.50(B)(1), 4723.151(C),
4730.02(E), 4730.03(F), 4730.39(B)(2), 4730.42(A)(1); Ohio Adm.Code 4723-9-10(K), 4730-2-
07(E). Abortion providers and APCs who violate the APC Ban face criminal charges, civil
penalties, civil forfeiture, and professional sanctions. By preventing qualified APCs from
providing medication abortion care, the APC Ban restricts the number of available abortion
providers throughout Ohio, which in turn delays and impedes access to abortion throughout the
State, risking harm to Ohioans’ health and well-being.
Third, the Evidence-Based Use Ban restricts the evidence-based use of the drug
mifepristone—one of the two main drugs used in medication abortions—solely with respect to
abortion care by forcing abortion providers to use mifepristone only in accordance with the FDA’s
label for the drug. R.C. 2919.123. Prescribing an FDA-approved drug for use in a manner not
specified by the FDA label (i.e., “evidence-based” or “off-label” use) is extremely common and
accepted in medical practice, and is often the safest and most effective way to use a drug according
to the best medical evidence. Providers who fail to prescribe mifepristone for abortion in exact
accordance with the FDA’s final printed labeling face felony criminal penalties, fines, and
professional sanctions. R.C. 2919.123(A), (F)(1). Because of the Evidence-Based Use Ban,
mifepristone is only available to Ohio patients through 70 days after the first day of their last
menstrual period (“LMP”)—even though research has demonstrated the efficacy and safety of use
of mifepristone beyond that window. Accordingly, patients between 70 days LMP and the point
in pregnancy up to which medication abortion can be provided according to evidence-based
standards are left with a difficult choice: seek a procedural abortion, which may be contraindicated,
traumatizing, or significantly less manageable for certain patients; travel out of state for medication
6
abortion care; seek medication abortion care outside the medical system; or carry an unwanted
pregnancy to term.
Individually and collectively, the Challenged Laws “burden, penalize, . . .interfere with,
[and] discriminate against” both Ohioans who seek to exercise their fundamental right to abortion
and Plaintiffs who assist Ohioans in exercising that right by providing abortion care, by delaying,
impeding, and restricting access to medication abortion. Ohio does not restrict the use of
mifepristone for non-abortion related purposes, thus explicitly discriminating against people
seeking abortions. In some cases, these restrictions may even prohibit Ohioans from making and
carrying out their own reproductive decisions entirely by pushing patients past the window in
which medication abortion is legally available in Ohio. Moreover, these restrictions provide no
countervailing benefit to patient health, let alone through the least restrictive means. For these
reasons, Plaintiffs have more than sufficiently established a prima facie showing of support for the
new claim under Article I, Section 22.
Moreover, none of the factors that weigh against granting leave to amend is present in this
case. First, Defendants cannot argue that Plaintiffs’ Motion represents an undue delay. The
Amendment did not go into effect until December 7, 2023, and Plaintiffs thereafter retained new
counsel in this matter. See Feb. 14, 2024 Order (granting Diamond Motion for Admission).
Defendants consented to Plaintiffs’ requests to extend the time to move to file their Amended
Complaint twice, up to a provisional filing date of May 13, 2024, and therefore cannot claim
prejudice arising from any related postponement. Cf. Shavel v. Shavel, 2023-Ohio-4876, ¶¶ 42-43
(11th Dist.) (finding no undue delay in moving to amend under Civ.R. 15(A) in part because
movant’s actions put non-movant on notice of new claims and thus provided counsel with
sufficient time to prepare).
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Second, Defendants will not be prejudiced by the added cause of action or parties because
this lawsuit is still in its early stages before this Court. Indeed, prior to the Court’s entry of a stay,
discovery had only just begun, with the Ohio Department of Health, Bruce T. Vanderhoff, and the
State Medical Board of Ohio filing their Initial Disclosures on December 15, 2021. See Elder v.
Fischer, 129 Ohio App.3d 209, 223, 717 N.E.2d 730 (1st Dist. 1998). As a result, permitting
Plaintiffs to file an Amended Complaint with a new claim and additional parties will not delay the
proceedings. In fact, granting leave to amend is in the interest of all parties, as Plaintiffs’ new
dispositive claim under the Amendment presents a purely legal question, thus allowing a speedy
and streamlined resolution of this case. See Lemons v. State, 2017-Ohio-8584, 100 N.E.3d 871,
¶ 146 (8th Dist.) (concluding “the state was not prejudiced” where a reasserted claim presented a
“merely a question of law”).
III. CONCLUSION
For the foregoing reasons, Plaintiffs respectfully request that this motion for leave to
amend the Complaint be granted.
A proposed order will be filed separately.
Respectfully submitted,
/s/__Michelle Nicole Diamond______ B. Jessie Hill (0074770)

Michelle Nicole Diamond (Pro Hac Vice) Margaret Light-Scotece (0096030)
Peter Neiman (Pro Hac Vice) Freda J. Levenson (0045916)
Maura Douglas (Pro Hac Vice) ACLU of Ohio Foundation
Meghan Koushik (Pro Hac Vice) 4506 Chester Ave.
Zach Blair (Pro Hac Vice) Cleveland, OH 44103
Nicole Castillo (Pro Hac Vice) (216) 368-0553
WilmerHale LLP (614) 586-1974 (fax)
7 World Trade Center bjh11@cwru.edu
New York, NY 10007 margaret.light-scotece@case.edu
(212) 230-8800 flevenson@acluohio.org
michelle.diamond@wilmerhale.com
8
peter.neiman@wilmerhale.com David J. Carey (0088787)
ACLU of Ohio Foundation
Alyssa Milstead (Pro Hac Vice) 1108 City Park Ave., Ste. 203
WilmerHale LLP Columbus, OH 43206
2600 El Camino Real, Suite 400 (380) 215-0997
Palo Alto, CA 94306 dcarey@acluohio.org
(650) 858-6000
alyssa.milstead@wilmerhale.com Meagan Burrows*
Johanna Zacarias*
Catherine Humphreville (Pro Hac Vice) American Civil Liberties Union
Vanessa Pai-Thompson (Pro Hac Vice) 125 Broad St., 18th Fl.
Planned Parenthood Federation of America New York, NY 10004
123 William Street, 9th Floor (212)-549-2601
New York, NY 10038 mburrows@aclu.org
(212) 541-7800 (Pai-Thompson) jzacarias@aclu.org
(212) 247-6811 (fax)
catherine.humphreville@ppfa.org Fanon A. Rucker #0066880
vanessa.pai-thompson@ppfa.org The Cochran Firm
527 Linton Street
Cincinnati, OH 45219
(513) 381-4878
(513) 672-0814 (fax)
frucker@cochranohio.com
Counsel for Plaintiffs
*Motion for pro hac vice forthcoming
Dated: May 9, 2024
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CERTIFICATE OF SERVICE
I hereby certify that on May 9, 2024, the foregoing was electronically filed via the Court’s
e-filing system. I further certify that a copy of the foregoing was served via electronic mail upon
counsel for the following parties:
OHIO DEPARTMENT OF HEALTH

246 N. High Street
Columbus, OH 43215
Email: Amanda.Narog@OhioAGO.gov
BRUCE T. VANDERHOFF, M.D., MBA

Director, Ohio Department of Health
246 N. High Street
Columbus, OH 43215
Email: Amanda.Narog@OhioAGO.gov
KIM G. ROTHERMEL, M.D.

Secretary, State Medical Board of Ohio
30 E. Broad Street, 3rd Floor
Columbus, OH 43215
Email: Kim.Rothermel@Med.Ohio.gov
HARISH KAKARALA, M.D.

Supervising Member, State Medical Board of Ohio
Columbus, OH 43215
Email: harish.kakarala@med.ohio.gov; kakarah@ccf.org
ERIN KEELS, DNP, APRN-CNP

President, Ohio State Board of Nursing
8995 East Main Street
Reynoldsburg, OH 43068
Email: BoardMembers@Nursing.Ohio.gov
CANDY SUE RINEHART, DNP, APRN-CNP

Supervising Member for Disciplinary Matters, Ohio State Board of Nursing
Email: BoardMembers@Nursing.Ohio.gov
MELISSA POWERS
Hamilton County Prosecutor
230 E. Ninth Street, Suite 4000
Email: melissa.powers@hcpros.org
G. GARY TYACK
Franklin County Prosecutor
373 S. High Street, 14th Floor
Columbus, OH 43215
Email: gtyack@franklincountyohio.gov
MICHAEL C. O’MALLEY
Cuyahoga County Prosecutor
Justice Center, Courts Tower
1200 Ontario Street, 9th Floor
Cleveland, OH 44113
Email: mcomalley@prosecutor.cuyahogacounty.us
MATHIAS H. HECK, JR.

Montgomery County Prosecutor
301 W. Third St., 5th Floor
P.O. Box 972
Dayton, OH 45402
Email: heckm@mcohio.org
ELLIOT KOLKOVICH
Summit County Prosecutor
175 S. Main Street
Akron, OH 44308
Email: ekolkovich@prosecutor.summitoh.net
KELLER J. BLACKBURN
Athens County Prosecutor
Athens County Courthouse
1 South Court Street, First Floor
Athens, OH 45701
Email: kim@athenscountyprosecutor.org
KYLE L. STONE
Stark County Prosecutor
110 Central Plaza South, Suite 510
Canton, OH 44702
Email: klstone@starkcountyohio.gov
VICTOR V. VIGLUICCI
Portage County Prosecutor
The Portage County Prosecutor’s Office
241 South Chestnut Street
Ravenna, OH 44266
Email: vvigluicci@portageco.com
JODIE M. SCHUMACHER
Richland County Prosecutor
38 South Park Street, 2nd Floor
Mansfield, OH 44902
Email: Jschumacher@richlandcountyoh.us
JULIA R. BATES
Lucas County Prosecutor
Common Pleas Court
700 Adams Street
Toledo, OH 43604
Email: jbates@co.lucas.oh.us
GINA DEGENOVA
Mahoning County Prosecutor
21 W Boardman Street, 6th Floor
Youngstown, OH 44503
Email: gina.degenova@mahoningcountyoh.gov
MICHAEL T. GMOSER
Butler County Prosecutor
315 High Street, 11th Floor
P.O. Box 515
Hamilton, OH 45012
Email: gmosermt@butlercountyohio.org
DANIEL P. DRISCOLL
Clark County Prosecutor
50 E. Columbia Street, Suite 449
Springfield, OH 45502
Email: ddriscoll@clarkcountyohio.gov
PLANNED PARENTHOOD
SOUTHWEST OHIO REGION, et al.,
Case No. A 2101148
Plaintiffs,
Judge Alison Hatheway
v.
PLAINTIFFS’ MOTION FOR
OHIO DEPARTMENT OF HEALTH, et al., LEAVE TO FILE AMENDED
COMPLAINT with EXHIBITS 1
Defendants. through 8
Exhibit 1
PLANNED PARENTHOOD
SOUTHWEST OHIO REGION
C/O WilmerHale LLP
7 World Trade Center
250 Greenwich Street
New York, NY 10007
SHARON LINER, M.D.

C/O WilmerHale LLP
New York, NY 10007
JULIA QUINN
C/O WilmerHale LLP
New York, NY 10007 Case No. A 2101148
PLANNED PARENTHOOD OF Judge Alison Hatheway

GREATER OHIO
C/O WilmerHale LLP [PROPOSED] AMENDED COMPLAINT
7 World Trade Center FOR DECLARATORY AND
250 Greenwich Street INJUNCTIVE RELIEF
New York, NY 10007
PRETERM-CLEVELAND
C/O B. Jessie Hill
ACLU of Ohio
4506 Chester Avenue
Cleveland, Ohio 44103
WOMEN’S MED GROUP

PROFESSIONAL CORPORATION
C/O B. Jessie Hill
ACLU of Ohio
4506 Chester Avenue
Cleveland, Ohio 44103
Plaintiffs,
v.
1
OHIO DEPARTMENT OF HEALTH
246 N. High Street
Columbus, OH 43215
BRUCE T. VANDERHOFF, M.D., MBA

Director, Ohio Department of Health
246 N. High Street
Columbus, OH 43215
KIM G. ROTHERMEL, M.D.

Secretary, State Medical Board of Ohio
Columbus, OH 43215
HARISH KAKARALA, M.D.

Supervising Member, State Medical Board
of Ohio
Columbus, OH 43215
ERIN KEELS, DNP, APRN-CNP

President, Ohio State Board of Nursing
CANDY SUE RINEHART, DNP, APRN-

CNP
Supervising Member for Disciplinary
Matters, Ohio State Board of Nursing
MELISSA POWERS
Hamilton County Prosecutor
230 E. Ninth Street, Suite 4000
G. GARY TYACK
Franklin County Prosecutor
373 S. High Street, 14th Floor
Columbus, OH 43215
MICHAEL C. O’MALLEY
Cuyahoga County Prosecutor
Justice Center, Courts Tower
2
1200 Ontario Street, 9th Floor
Cleveland, OH 44113
MATHIAS H. HECK, JR.

Montgomery County Prosecutor
301 W. Third St., 5th Floor
P.O. Box 972
Dayton, OH 45402
ELLIOT KOLKOVICH
Summit County Prosecutor
175 S. Main Street
Akron, OH 44308
KELLER J. BLACKBURN
Athens County Prosecutor
Athens County Courthouse
1 South Court Street, First Floor
Athens, OH 45701
KYLE L. STONE
Stark County Prosecutor
110 Central Plaza South, Suite 510
Canton, OH 44702
VICTOR V. VIGLUICCI
Portage County Prosecutor
The Portage County Prosecutor’s Office
241 South Chestnut Street
Ravenna, OH 44266
JODIE M. SCHUMACHER
Richland County Prosecutor
38 South Park Street, 2nd Floor
Mansfield, OH 44902
JULIA R. BATES
Lucas County Prosecutor
Common Pleas Court
700 Adams Street
Toledo, OH 43604
GINA DEGENOVA
Mahoning County Prosecutor
21 W Boardman Street, 6th Floor
Youngstown, OH 44503
3
MICHAEL T. GMOSER
Butler County Prosecutor
315 High Street, 11th Floor
P.O. Box 515
Hamilton, OH 45012
DANIEL P. DRISCOLL
Clark County Prosecutor
50 E. Columbia Street, Suite 449
Springfield, OH 45502
Defendants.
INTRODUCTION
1. On November 7, 2023, Ohioans voted to amend the Ohio Constitution to protect an
individual’s “right to make and carry out one’s own reproductive decisions, including but not
limited to decisions on . . . abortion.” Ohio Constitution, Article I, Section 22(A) (the
“Amendment”). Pursuant to this explicit constitutional right to abortion, the State may not
“directly or indirectly, burden, penalize, prohibit, interfere with, or discriminate against” either the
exercise of Ohioans’ decision to have an abortion or any “person or entity” that assists them in
exercising that right, unless the State demonstrates that it is using the “least restrictive means to
advance the individual’s health in accordance with widely accepted and evidence-based standards
of care.” Ohio Constitution, Article I, Section 22(B). As Ohio Attorney General Dave Yost
acknowledged prior to the Amendment’s passage, the Amendment “creates a new, legal standard”
that provides greater protection to reproductive freedom than federal precedent predating the U.S.
Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, 597 U.S. 215, 142
S. Ct. 2228, 213 L.Ed.2d 545 (2022).1
1
Ohio Atty. Gen., Issue 1 on the November 2023 Ballot: A Legal Analysis by the Ohio Attorney General 3 (Oct 5,
2023), https://www.ohioattorneygeneral.gov/SpecialPages/FINAL-ISSUE-1-ANALYSIS.aspx.
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2. Plaintiffs challenge three categories of restrictions on medication abortion that
directly and indirectly burden, penalize, interfere with, and discriminate against an individual’s
exercise of their right to abortion, and healthcare providers who provide abortion care, without
providing any countervailing health benefit: (1) the Telemedicine Ban, (2) the Advanced Practice
Clinician (“APC”) Ban, and (3) the Evidence-Based Use Ban (collectively, the “Challenged
Laws”) (attached hereto as Exhibits 4–6). With respect to Ohioans for whom medication abortion
is the only viable option, the Challenged Laws may also prohibit patients from making and carrying
out their reproductive decisions entirely, by pushing them beyond the point in pregnancy when
medication abortion is available. This is particularly true given the intersecting burdens the
Challenged Laws impose on medication abortion access.
3. Moreover, the Challenged Laws do nothing to advance patient health in accordance
with widely accepted and evidence-based standards of care, let alone by employing the least
restrictive means of doing so. To the contrary, by delaying and impeding Ohioans’ access to time-
sensitive, vital abortion care, the Challenged Laws only serve to affirmatively harm patient health
and well-being.
4. The Telemedicine Ban prohibits abortion providers from providing medication
abortion to Ohioans through telemedicine. See Senate Bill No. 260, 2020 Ohio Laws File 113
(adding R.C. 2919.124) (“SB 260”). The Telemedicine Ban restricts access to abortion and
threatens draconian felony criminal penalties and civil and professional sanctions for abortion
providers who violate it. Telemedicine medication abortion (“TMAB”) has been studied
extensively and determined to be safe and effective, preferred by many patients, and critical to
expanding abortion access to underserved areas and reducing travel and related burdens on
patients. This Court previously enjoined enforcement of the Telemedicine Ban before it went into
5
effect. See Entry Granting Pls.’ Mot. Prelim. Inj., at 7 (Apr. 19, 2021). If not for the injunction,
the Telemedicine Ban would substantially increase the distances that many patients must travel to
obtain medication abortions, which in turn would delay and impede access to abortion, risking
harm to Ohioans’ health and well-being.
5. The APC Ban is a group of laws that together restrict qualified and skilled
advanced practice clinicians (“APCs”) from providing medication abortion, regardless of their
education, training, and experience, even though Ohio permits them to prescribe the exact same
medications for other purposes. See R.C. 2317.56(B), 2919.11, 2919.123, 4723.44(B)(6),
4723.50(B)(1), 4723.151(C), 4730.02(E), 4730.03(F), 4730.39(B)(2), 4730.42(A)(1); Ohio
Adm.Code 4723-9-10(K), 4730-2-07(E). Abortion providers and APCs, including physician
assistants (“PAs”), certified nurse-midwives (“CNMs”),2 and nurse practitioners (“NPs”), who
violate the APC Ban face criminal charges, civil penalties, civil forfeiture, and professional
sanctions. By preventing qualified APCs from providing medication abortion care, the APC Ban
restricts the number of available abortion providers throughout Ohio, which in turn delays and
impedes access to abortion throughout the State, risking harm to Ohioans’ health and well-being.
6. The Evidence-Based Use Ban restricts the evidence-based use of the drug
mifepristone solely with respect to abortion care, by forcing abortion providers to prescribe
mifepristone only in accordance with the U.S. Food and Drug Administration’s (“FDA”) label for
the drug. R.C. 2919.123. Prescribing an FDA-approved drug for use in a manner not specified by
the FDA label (i.e., “evidence-based” or “off-label” use) is extremely common, well accepted in
medical practice, safe, and effective. The Evidence-Based Use Ban singles out medication
abortion for differential and unfavorable treatment when it comes to mifepristone, because Ohio
2
NPs and CNMs are both types of advanced practice registered nurses (“APRNs”).
6
permits off-label use of mifepristone for other purposes, including miscarriage management.
Providers who fail to prescribe mifepristone for abortion in exact conformance with the FDA’s
final printed labeling face felony criminal penalties, fines, and professional sanctions. R.C.
2919.123. Because of the Evidence-Based Use Ban, mifepristone is only available to Ohio patients
for abortion through 70 days from the first day of their last menstrual period (“LMP”)—even
though research has demonstrated the efficacy and safety of mifepristone for abortion beyond that
window. Accordingly, patients beyond 70 days LMP and before the point in pregnancy up to
which medication abortion can be provided according to evidence-based standards are left with a
difficult choice: seek a procedural abortion, which may be contraindicated, traumatizing, or
significantly less manageable for certain patients; travel out of state for medication abortion care;
seek medication abortion care outside the medical system; or in some cases, potentially carry an
unwanted pregnancy to term.
7. Plaintiffs, who are reproductive health care providers in Ohio, seek preliminary and
permanent injunctive relief to prevent the Challenged Laws’ enforcement and a declaratory
judgment that the Challenged Laws violate the Ohio Constitution.
PARTIES
A. Plaintiffs
8. Planned Parenthood Southwest Ohio Region (“PPSWO”) is a nonprofit
corporation organized under the laws of the State of Ohio. PPSWO and its predecessor
organizations have provided a broad range of high-quality reproductive health care to patients in
southwest Ohio since 1929. PPSWO provides abortions, including medication abortion through
70 days LMP, at its ambulatory surgical facility (“ASF”) in Cincinnati. PPSWO and its physicians
offer TMAB that would be barred by the Telemedicine Ban if not for the preliminary injunction
previously entered in this case. Absent the APC Ban, PPSWO APCs would train in and begin to
7
provide medication abortion, and PPSWO would hire additional APCs as needed to provide this
care. Absent the Evidence-Based Use Ban, PPSWO clinicians would prescribe mifepristone
according to evidence-based standards and as clinically indicated, including beyond 70 days LMP.
Providers at PPSWO are threatened with criminal charges, loss of their licenses, civil penalties,
civil forfeiture, and civil suits if they provide care in violation of the Challenged Laws. PPSWO
sues on behalf of itself; its current and future physicians, APCs, staff, officers, and agents; and its
patients.
9. Sharon Liner, M.D., is a physician licensed to practice medicine in Ohio. Dr.
Liner is the Medical Director at PPSWO, and she provides abortion from PPSWO’s Cincinnati
Surgical Center in Hamilton County. Dr. Liner offers TMAB that would be barred by the
Telemedicine Ban if not for the preliminary injunction previously entered in this case. Absent the
Evidence-Based Use Ban, Dr. Liner would prescribe mifepristone according to evidence-based
standards and as clinically indicated, including beyond 70 days LMP. Dr. Liner faces criminal
penalties, loss of her medical license, civil penalties, civil forfeiture, and civil suits if she violates
the Telemedicine Ban or the Evidence-Based Use Ban. She sues on her own behalf and on behalf
of her patients.
10. Julia Quinn, MSN, WHNP-BC, is a board-certified NP, a type of APRN, at
PPSWO. Ms. Quinn provides a range of sexual and reproductive health care to her patients,
including, for example, prescribing contraception, inserting and removing long-acting
contraception (i.e., intrauterine devices and Nexplanon contraceptive implants), and prescribing
both pre- and post-exposure prophylaxis to prevent HIV. But for the APC Ban, Ms. Quinn would
train in and begin to provide medication abortion to patients at PPSWO. Ms. Quinn also would
offer TMAB that would be barred by the Telemedicine Ban if not for the preliminary injunction
8
previously entered in this case. In addition, absent the APC Ban and the Evidence-Based Use Ban,
Ms. Quinn would prescribe mifepristone according to evidence-based standards and as clinically
indicated, including beyond 70 days LMP. Ms. Quinn faces criminal penalties, loss of her nursing
license, civil penalties, civil forfeiture, and civil suits if she violates the APC Ban. She sues on
behalf of herself and her patients.
11. Planned Parenthood of Greater Ohio (“PPGOH”) is a nonprofit corporation
organized under the laws of the State of Ohio. PPGOH was formed in 2012 through a merger of
local and regional Planned Parenthood affiliates that had served patients in Ohio for decades by
providing high-quality reproductive health care. PPGOH serves patients in northern, eastern, and
central Ohio. PPGOH provides medication abortion through 70 days LMP at its ASFs in East
Columbus and Bedford Heights. PPGOH offers TMAB that would be barred by the Telemedicine
Ban if not for the preliminary injunction previously entered in this case. Absent the APC Ban,
PPGOH APCs would train in and begin to provide medication abortion. But for the Evidence-
Based Use Ban, PPGOH clinicians would prescribe mifepristone according to evidence-based
standards and as clinically indicated, including beyond 70 days LMP. Providers at PPGOH are
threatened with criminal charges, loss of their licenses, civil forfeiture, civil penalties, and civil
suits if they provide care in violation of the Challenged Laws. PPGOH sues on behalf of itself; its
current and future physicians, APCs, staff, officers, and agents; and its patients.
12. Women’s Med Group Professional Corporation (“WMGPC”) owns and
operates Women’s Med Dayton (“WMD”) in Kettering, Ohio. WMGPC and its predecessor
organizations have been providing abortions in the Dayton area since 1973. WMD is an ASF and
provides medication abortions through 70 days LMP. Absent the APC Ban, WMD would seek to
hire and train APCs to provide medication abortion and to staff a second clinic location that WMD
9
would open in the greater Cincinnati area to increase accessibility to abortion and reproductive
health care. Absent the Evidence-Based Use Ban, WMD clinicians would prescribe mifepristone
according to evidence-based standards and as clinically indicated, including beyond 70 days LMP.
Providers at WMD are threatened with criminal penalties, loss of their medical licenses, civil
penalties, civil forfeiture, and civil suits if they provide care in violation of the APC Ban and the
Evidence-Based Use Ban. WMGPC sues on behalf of itself; its current and future physicians,
APCs, staff, officers, and agents; and its patients.
13. Preterm-Cleveland (“Preterm”) is a nonprofit clinic in Cleveland, Ohio, which has
been serving patients since 1974. Preterm is an ASF under Ohio law. Preterm provides a range
of reproductive and sexual health care services, including abortion. Preterm provides medication
abortions through 70 days LMP. Absent the APC Ban, Preterm would seek to hire and train APCs
to provide medication abortion. Absent the Evidence-Based Use Ban, Preterm clinicians would
prescribe mifepristone according to evidence-based standards and as clinically indicated, including
beyond 70 days LMP. Providers at Preterm are threatened with criminal penalties, loss of their
medical licenses, civil penalties, civil forfeiture, and civil suits if they provide care in violation of
the APC Ban or the Evidence-Based Use Ban. Preterm sues on behalf of itself; its current and
future physicians, APCs, staff, officers, and agents; and its patients.
B. Defendants
14. The Ohio Department of Health (“ODH”) is the state agency charged with
licensing and overseeing the operation of ASFs, as health care facilities, in the State, including
ASFs operated by PPSWO, PPGOH, WMD, and Preterm. ODH can suspend, revoke, or decline
to renew Plaintiffs’ ASF licenses, order Plaintiffs’ ASFs to cease operations, and/or impose civil
penalties on Plaintiffs’ ASFs for violations of the Challenged Laws. See Ohio Adm.Code 3701-
83-05, -05.1, -.05.2, -09(A), -03(D).
10
15. Bruce Vanderhoff, M.D., is the Director of ODH. He can suspend, revoke, or
decline to renew Plaintiffs’ ASF licenses, order Plaintiffs’ ASFs to cease operations, and/or impose
civil penalties on Plaintiffs’ ASFs for violations of the Challenged Laws. See Ohio Adm.Code
3701-83-05, -05.1, -.05.2, -09(A), -03(D). He is sued in his official capacity.
16. Kim G. Rothermel, M.D., is the Secretary of the State Medical Board of Ohio
(the “Medical Board”), which is charged with enforcing physician and PA licensing. The Medical
Board has authority to act against a physician or PA’s license based on a commission of an
unlawful act, including a violation of the Challenged Laws, through license suspension or
revocation. See R.C. 4731.22, 4730.25. The Medical Board may also impose civil penalties for
violations. R.C. 4731.225(B), 4730.252. She is sued in her official capacity.
17. Harish Kakarala, M.D., is the Supervising Member of the Medical Board. The
Medical Board has authority to act against a physician or PA’s license based on a commission of
an unlawful act, including a violation of the Challenged Laws, through license suspension or
revocation. See R.C. 4731.22, 4730.25. The Medical Board may also impose civil penalties for
violations. R.C. 4731.225(B), 4730.252. He is sued in his official capacity.
18. Erin Keels, DNP, APRN-CNP, is the Board President of the Ohio Board of
Nursing (the “Nursing Board”), which is charged with enforcing NP and CNM licensing. The
Nursing Board has authority to act against an NP or CNM’s license based on commission of an
unlawful act, including a violation of the APC Ban, through license suspension or revocation. R.C.
4723.28(B). The Nursing Board may also impose civil penalties for violations. Id. She is sued in
her official capacity.
19. Candy Sue Rinehart, DNP, APRN-CNP, is the Supervising Member for
Disciplinary Matters of the Nursing Board, which is charged with enforcing NP and CNM
11
licensing. The Nursing Board has authority to act against an NP or CNM’s license based on
commission of an unlawful act, including a violation of the APC Ban, through license suspension
or revocation. R.C. 4723.28(B). The Nursing Board may also impose civil penalties for violations.
Id. She is sued in her official capacity.
20. Melissa Powers is the Hamilton County Prosecuting Attorney. She is responsible
for the enforcement of all criminal laws in Hamilton County, where two of PPSWO’s health
centers, including its Cincinnati Surgical Center, are located; where Dr. Liner and other PPSWO
physicians provide abortions, including TMAB; and where, if not for the APC Ban, Plaintiff Quinn
and other PPSWO APCs would train in and begin to provide medication abortion. She is sued in
her official capacity.
21. G. Gary Tyack is the Franklin County Prosecuting Attorney. He is responsible for
the enforcement of all criminal laws in Franklin County, where PPGOH’s East Columbus Surgical
Center is located; where PPGOH physicians provide abortions, including TMAB; and where, if
not for the APC Ban, PPGOH APCs would train in and begin to provide medication abortion. He
is sued in his official capacity.
22. Michael C. O’Malley is the Cuyahoga County Prosecutor. He is responsible for
the enforcement of all criminal laws in Cuyahoga County, where PPGOH’s Bedford Heights ASF
and Preterm’s ASF are located; where PPGOH and Preterm physicians provide abortion; and
where, if not for the APC Ban, PPGOH and Preterm would hire and/or train APCs to begin to
provide medication abortion. He is sued in his official capacity.
23. Mathias H. Heck, Jr. is the Montgomery County Prosecuting Attorney. He is
responsible for the enforcement of all criminal laws in Montgomery County, where WMD’s health
care clinic and one of PPSWO’s health centers are located; where WMD physicians provide
12
abortions; and where, if not for the APC Ban, PPSWO and WMD would hire and/or train APCs to
begin to provide medication abortion. He is sued in his official capacity.
24. Elliot Kolkovich is the Summit County Prosecutor. He is responsible for the
enforcement of all criminal laws in Summit County, where one of PPGOH’s health centers is
located; and where, if not for the APC Ban, PPGOH APCs would be able to train in and begin to
25. Keller J. Blackburn is the Athens County Prosecutor. He is responsible for the
enforcement of all criminal laws in Athens County, where one of PPGOH’s health centers is
26. Kyle L. Stone is the Stark County Prosecuting Attorney. He is responsible for the
enforcement of all criminal laws in Stark County, where one of PPGOH’s health centers is located;
and where, if not for the APC Ban, PPGOH APCs would be able to train in and begin to provide
medication abortion. He is sued in his official capacity.
27. Victor V. Vigluicci is the Portage County Prosecutor. He is responsible for the
enforcement of all criminal laws in Portage County, where one of PPGOH’s health centers is
28. Jodie M. Schumacher is the Richland County Prosecuting Attorney. She is
responsible for the enforcement of all criminal laws in Richland County; where one of PPGOH’s
health centers is located; and where, if not for the APC Ban, PPGOH APCs would be able to train
in and begin to provide medication abortion. She is sued in her official capacity.
13
29. Julia R. Bates is the Lucas County Prosecutor. She is responsible for the
enforcement of all criminal laws in Lucas County, where one of PPGOH’s health centers is located;
and where, if not for the APC Ban, PPGOH APCs would be able to train in and begin to provide
medication abortion. She is sued in her official capacity.
30. Gina DeGenova is the Mahoning County Prosecutor. She is responsible for the
enforcement of all criminal laws in Mahoning County, where one of PPGOH’s health centers is
provide medication abortion. She is sued in her official capacity.
31. Michael T. Gmoser is the Butler County Prosecuting Attorney. He is responsible
for the enforcement of all criminal laws in Butler County, where one of PPSWO’s health centers
is located; and where, if not for the APC Ban, PPSWO APCs would train in and begin to provide
medication abortion. He is sued in his official capacity.
32. Daniel P. Driscoll is the Clark County Prosecutor. He is responsible for the
enforcement of all criminal laws in Clark County, where one of PPSWO’s health centers is located;
and where, if not for the APC Ban, PPSWO APCs would train in and begin to provide medication
abortion. He is sued in his official capacity.
PROCEDURAL BACKGROUND
33. On April 1, 2021, PPSWO, Dr. Liner, and PPGOH brought this action seeking a
temporary restraining order followed by a preliminary injunction, as well as a declaratory
judgment and permanent injunctive relief, against the Telemedicine Ban. The Complaint asserted
claims for violations of the Ohio Constitution’s equal protection and benefit guarantee under
Article I, Section 2, and the Ohio Constitution’s protections for individual liberty under Article I,
Sections 1, 2, 16, 20, and 21.
14
34. On April 7, 2021, this Court issued a temporary restraining order. Following an
expedited briefing schedule and oral argument, the Court issued a preliminary injunction enjoining
enforcement of the Telemedicine Ban, finding that, absent relief, Ohioans would have suffered
irreparable deprivation of their constitutional rights and serious, irreparable harm to their physical,
psychological, and emotional well-being. That preliminary injunction is still in effect.
35. On July 13, 2022, the Court granted the original Plaintiffs’ Motion to Stay
Proceedings pending resolution of State ex rel. Preterm-Cleveland v. Yost, No. 2022-0803 (Ohio
June 29, 2022).
36. Since this Court’s grant of the original Plaintiffs’ Motion to Stay, the people of
Ohio voted to amend the Ohio Constitution to explicitly protect the right to abortion. Ohio
Constitution, Article I, Section 22. The Amendment took effect on December 7, 2023.
37. On December 15, 2023, the Ohio Supreme Court dismissed the appeal in State ex
rel. Preterm-Cleveland v. Yost, No. 2023-0004 (Ohio Dec. 15, 2023). This Court thereafter lifted
the stay in this case.
JURISDICTION AND VENUE
38. The Court has jurisdiction over this Amended Complaint pursuant to R.C. 2721.02,
2727.02, and 2727.03.
39. Venue is proper in this Court pursuant to Civ.R. 3(C)(4) because Defendant Powers
maintains her principal office in Hamilton County.
40. Venue is further proper in this Court pursuant to Civ.R 3(C)(3) because Defendant
Powers initiates prosecutions in Hamilton County.
41. Venue is further proper in this Court pursuant to Civ.R. 3(C)(6) because Plaintiffs
PPSWO, Dr. Liner, and Ms. Quinn provide reproductive health care services in Hamilton County,
so the business, professional and other injuries caused by the Challenged Laws with respect to
15
them occur in Hamilton County, and Defendant Powers would bring any resulting prosecutions
against Dr. Liner, Ms. Quinn, or other PPSWO physicians or APCs in Hamilton County. In
addition, judicial proceedings to adjudicate ODH enforcement action over violations of the
Challenged Laws would occur in Hamilton County. See R.C. 119.12(B)(2).
ALLEGATIONS
A. Abortion is an Essential Component of Health Care
42. Abortion is extremely common in the United States. Approximately one in four
women in this country will have had an abortion by age 45.
43. Two types of abortion are available in Ohio: medication and procedural abortion.
This case concerns restrictions on medication abortion.
44. The most common regimen of medication abortion involves a combination of two
medications: mifepristone and misoprostol. Medication abortion patients first take mifepristone
orally, which blocks the hormone progesterone. Progesterone is necessary to maintain pregnancy.
Then, typically 24 to 48 hours later, patients take misoprostol, which causes the uterus to contract
and expel its contents, in a process similar to miscarriage.
45. The decision to terminate a pregnancy is an incredibly personal decision that is
informed by a combination of diverse, complex, and interrelated factors that are intimately related
to an individual’s values, beliefs, culture, religion, health status, reproductive history, familial
situation, resources, and economic stability.
46. Most people who seek abortion have already given birth at least once, and many
pregnant people seek an abortion because they feel they cannot adequately care for another child;
because they want to prioritize the needs of their existing children; or because of other caretaking
responsibilities. For some, an additional child can place significant economic and emotional strain
16
on a family. A significant majority of people seeking abortions in the United States are either poor
or low-income.
47. Some people seek abortions because they simply do not want to become a parent at
that point in their lives, or ever. For some people, having a child will make it too difficult for them
to pursue educational, career, or other life goals and support themselves and their families going
forward.
48. People experiencing intimate partner violence may seek abortion to escape the
dangers posed by their relationships, which can be amplified by pregnancy and parenting.
49. Survivors of sexual assault or incest may choose abortion to avoid the ongoing
emotional distress and trauma associated with carrying a pregnancy resulting from their assault,
regain control over their bodies and reproductive choices, facilitate their healing process, and/or
prevent further ties to their assailant through parenthood.
50. Others seek an abortion because continuing their pregnancies would threaten their
health or life due to pre-existing medical conditions or complications that arise during pregnancy.
51. Individual circumstances vary greatly, and the reasons outlined above are not
exhaustive but rather examples of the diverse factors that may influence someone’s decision to
seek abortion. People seeking abortion often base their decision on multiple interconnected factors
and considerations.
52. Whatever a person’s reasons, accessing abortion is essential to their autonomy,
dignity, and ability to care for themselves and their families. Forcing a person to continue a
pregnancy against their will jeopardizes their physical, mental, and emotional health, as well as
the stability and well-being of their family and existing children.
17
53. Patients generally seek abortion as soon as they are able to, but many face logistical
obstacles that can delay access to abortion. Patients need to schedule an appointment, gather the
resources to pay for the abortion and related costs, arrange transportation to a clinic, take time off
work (often unpaid, due to a lack of paid time off or sick leave), and possibly arrange for child
care during appointments. The delay caused by these barriers and others posed by the Challenged
Laws results in higher financial, physical, and emotional costs to the patient. These burdens fall
most heavily on patients with low incomes, patients who live far from health centers, patients of
color, patients with children, patients under the age of 18, and patients experiencing interpersonal
violence.3
B. Abortion Is Extremely Safe
54. Legal abortion is very safe. Complications from both medication and procedural
abortions are extremely rare. In the rare cases where complications from medication abortion
occur, they can typically be managed in an outpatient clinic setting.
55. Medication abortion is one of the safest treatments in contemporary medical
practice. Current medical evidence demonstrates that medication abortion is safe and effective
through at least 77 days LMP.
56. Despite this evidence, the Evidence-Based Use Ban prevents patients after 70 days
LMP from obtaining medication abortion. See infra ¶¶ 143–50; R.C. 2919.123.
57. For some patients, medication abortion may be safer than procedural abortion due
to complications of the patient’s reproductive and genital tract, such as large uterine fibroids, that
3
These barriers are further exacerbated by the fact that Ohio law requires patients to receive certain state-mandated
information at least 24 hours before their abortion, forcing most patients to make at least two trips to a health center
for care. See infra ¶ 69.
18
make accessing the pregnancy inside the uterus as part of a procedural abortion difficult or
impossible.
58. Many patients also prefer medication abortion because they can end their pregnancy
at home and at a time more suitable for them and because it allows them more privacy and
autonomy. Victims of rape, sexual abuse, or molestation may choose medication abortion to feel
more in control of the experience and to avoid trauma from having instruments inserted through
their vaginas.
59. Regardless of the method of abortion, abortion is substantially safer than continuing
a pregnancy through childbirth. The national risk of maternal mortality associated with live birth
is approximately 14 times higher than the risk of death associated with induced abortion. The
maternal mortality rate is significantly higher for Black women in Ohio, where they are 1.5 to 2.5
times more likely than white women to die of causes related to pregnancy. 4 Indigenous women
also face higher maternal mortality rates than white women.
60. Even for the healthiest patients, pregnancy poses extraordinary physical challenges
and significant health risks. Pregnancy places significant stress on most major organs and results
in profound and long-lasting physiological changes.
61. Pregnancy complications are also extremely common. Some of the more common
complications include preeclampsia, gestational diabetes, and maternal cardiac disease. All of
4
According to Ohio statistics from 2008–2016, non-Hispanic Black women were more than 2.5 times as likely to die
from pregnancy-related causes than their white counterparts. Ohio Dept. of Health, A Report on Pregnancy-
Associated Deaths in Ohio 2008–2016, at 19 (2019), https://bit.ly/3uZraej (accessed Apr. 25, 2024). However, in
2017–2018, due to the adoption of new criteria employed by ODH “to determine the pregnancy-relatedness of
unintentional overdose deaths, an increased number of unintentional overdose deaths were determined to be pregnancy
related in 2017 and 2018,” and the majority of those occurred among non-Hispanic white women. Ohio Dept. of
Health, A Report on Pregnancy-Related Deaths in Ohio 2017–2018, at 4, 28 (2022), http://bit.ly/4b1iSXx (accessed
Apr. 25, 2024). However, “pregnancy-related deaths due to causes other than overdose occurred disproportionately
among non-Hispanic Black women.” Id. at 4, 28.
19
these conditions can result in serious, permanent harm to an individual’s health, up to and including
death.
62. Pregnancy may also cause or exacerbate certain health conditions, such as diabetes,
hypertension, asthma, heart disease, an autoimmune disorder, or renal disease. People with such
conditions face an even greater risk of experiencing medical complications during pregnancy.
63. Forcing someone to continue a pregnancy against their will poses severe risks to
their physical, mental, and emotional health, as well as to the stability and well-being of their
family, including their existing children.
64. While abortion is always very safe, the risks associated with it do increase as
pregnancy progresses. Accordingly, when patients seeking abortion are unnecessarily delayed in
accessing that care, they are subjected not only to the harms associated with being forced to remain
pregnant for longer, but also to increased risks from abortion, if and when they eventually obtain
their desired care.
C. Plaintiffs’ Abortion Services
65. PPSWO, PPGOH, WMD, and Preterm provide a broad range of sexual and
reproductive health services throughout Ohio.
66. PPSWO operates five clinics in southwest Ohio, and PPGOH operates another 15
clinics throughout the rest of the State. WMD is a clinic in Kettering, Ohio, and Preterm is a clinic
in Cleveland, Ohio.
67. Ohio law requires clinics that offer procedural abortion (sometimes called surgical
abortion) to be ASFs. Five of these clinics offer procedural abortion: PPSWO’s Cincinnati ASF,
PPGOH’s East Columbus and Bedford Heights ASFs, WMD, and Preterm. Each of the ASFs has
one or more physicians at the facility each day it offers services.
20
68. The remaining health centers operated by PPSWO and PPGOH (i.e., the non-ASF
centers) have one or more APCs on site. Other medical professionals, such as registered nurses,
licensed practical nurses, and/or medical assistants, also staff each center.
69. Regardless of the method of abortion, abortion patients in Ohio are required by law
to travel to a clinic or health center to receive certain state-mandated information in person at least
24 hours prior to obtaining abortion care. See R.C. 2317.56(B)(1), 2919.192-94. For most
patients, this means that they must make at least two trips to a clinic or health center in order to
obtain an abortion: the first to receive the state-mandated information (the “Day 1” visit) and the
second—at least 24 hours later, if not much longer—to obtain their abortion (the “Day 2” visit).5
70. Ohio law requires the Day 1 mandatory, in-person information session to be
completed by a physician. See R.C. 2317.56(B)(1). Thus, PPGOH and PPSWO can offer Day 1
visits only at their three ASFs (i.e., their surgical centers in Cincinnati, East Columbus, and
Bedford Heights), where physicians are regularly on site. It would not be operationally feasible
for PPGOH or PPSWO to place physicians in their non-ASFs to provide Day 1 visits.
D. The Challenged Laws
1. Telemedicine Ban
71. The Telemedicine Ban prohibits abortion providers from providing medication
abortion to Ohioans through telemedicine. This prohibition directly and indirectly burdens,
penalizes, interferes with, discriminates against and, in some cases, may prohibit patients’
exercise of their right to abortion and inhibits Plaintiffs from assisting patients in exercising this
right.
5
See Complaint, Preterm-Cleveland v. Yost, Franklin C.P. No. 24 CV 2634 (Mar. 29, 2024). A small minority of
medication abortion patients in Ohio are able to obtain a medication abortion with one in-person visit to a clinic
followed by a virtual visit at least 24 hours later. However, Ohio law currently requires these patients to schedule two
separate appointments—and to delay their care for at least 24 hours. See id. ¶ 84.
21
72. The Ohio General Assembly passed the Telemedicine Ban on December 17, 2020,
and Governor DeWine signed it into law on January 9, 2021. While the Telemedicine Ban was
slated to take effect on April 12, 2021, this Court issued a temporary restraining order followed by
a preliminary injunction blocking its enforcement.
73. Had the Telemedicine Ban not been enjoined by this Court, R.C. 2919.124(B)
would have barred a clinician from providing an “abortion-inducing drug” to a pregnant person
unless the clinician is “physically present at the location where the initial dose of the drug or
regimen of drugs is consumed at the time” the patient consumes that dose. SB 260, § 1 (adding
R.C. 2919.124(A)(l), (B)).
74. The Telemedicine Ban would also make it illegal for a clinician to “knowingly fail
to comply with division (B) of this section” when the clinician provides “an abortion-inducing
drug to another” for “the purpose of inducing an abortion.” SB 260, § 1 (adding R.C.
2919.124(C)).
75. The Telemedicine Ban defines “abortion-inducing drug” to include mifepristone,
the first medication in the most common medication abortion regimen. SB 260, § 1 (adding R.C.
2919.124(A)(l)). However, it also sweeps in any other “drug or regimen of drugs that causes the
termination of a clinically diagnosable pregnancy.” Id. (adding R.C. 2919.124(A)(l)).
76. A violation of the Telemedicine Ban is a fourth-degree felony, which carries a
potential prison term of between six and eighteen months in Ohio. SB 260, § 1 (adding R.C.
2919.124(E)); see R.C. 2929.14(A)(4)). Licensed physicians are also “subject to sanctioning” by
the Medical Board for violations of the Telemedicine Ban. SB 260, § 1 (adding R.C. 2919.124(E),
which cross-references R.C. 4731.22); see also R.C. 2925.01(W)(l7).
22
77. For a second or subsequent violation of the Telemedicine Ban, a physician is
subject to mandatory and automatic medical license suspension for at least one year. SB 260, § 1
(amending R.C. 4731.22(I)(1)). That is so even though Ohio law otherwise reserves this automatic
suspension penalty to several far more serious crimes, such as aggravated murder, felonious
assault, kidnapping, and rape. R.C. 4731.22(I).
a. Benefits of Telemedicine Care
78. Telemedicine is a common and effective way to provide health care. Telemedicine
refers to traditional clinical diagnosis and monitoring that a health care provider delivers live to
patients via secure audio and/or video. Telemedicine allows patients to interact in real-time with
health care providers who are physically distant.
79. Telemedicine is used for a wide range of services, from emergency care to
psychotherapy, and in many different settings, including in general medical practices, urgent cares,
hospitals, and specialists’ offices. The need for telemedicine in reproductive and sexual health
care is particularly acute given provider shortages.
80. Although some obstetric and gynecological care can only be done in person,
telemedicine can be used to provide a range of medical interventions and treatments, including
some that carry far greater medical risks than medication abortion.
81. Ohio and federal government officials alike have recognized telemedicine’s
benefits. For example, Governor DeWine has stated that Ohio policymakers now “realize[ ] that
when you need healthcare and behavioral health services, a virtual visit can save time and money.”
23
and he has touted a law to permanently expand insurance coverage of telehealth. 6 In 2017, then-
Attorney General DeWine criticized “bureaucracy” standing in the “way of innovative programs
like telemedicine and remote prescribing.”7
82. The U.S. Department of Health and Human Services acknowledges numerous
benefits to telemedicine, including that it can reduce travel time, obviate the need to take time off
from work or the need to find child care; shorten wait times to meet with a provider; and increase
patients’ access to specialists who live farther away.8 After the COVID-19 public health
emergency, many of the Department’s telehealth policies implemented during that time have been
made permanent, while others have been extended through December 31, 2024.9
83. Recognizing these valuable benefits of telemedicine, Ohio has taken steps to reduce
legal and regulatory barriers to telemedicine. These aspects of Ohio law are consistent with efforts
in many other states to reduce impediments to telemedicine and thereby increase availability of
health care. For example, Ohio has adopted flexible licensing rules to facilitate telemedicine. State
law permits the creation of a physician-patient relationship without an in-person medical
evaluation, provided the standard of care is met. Ohio Adm.Code 4731-11-09(C)–(F); R.C.
4731.74(B). Physicians may prescribe non-controlled substances on that basis. R.C.
6
Governor Mike DeWine, As Prepared State of the State Address, 3 (Mar. 23, 2022),
https://governor.ohio.gov/wps/wcm/connect/gov/27cd3f50-5604-4a35-a531-
32914135ec0b/As+Prepared+2022+Governor+Mike+DeWine+State+of+the+State+Remarks.pdf?MOD=AJPERES
&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000-27cd3f50-
5604-4a35-a531-32914135ec0b-n-Z8q2E.
7
Press Release, Mike DeWine, Statement from Ohio Attorney General Mike DeWine Following the President’s
Declaration of National Public Health Emergency on Opioids (Oct. 26, 2017),
https://www.ohioattorneygeneral.gov/Media/News-Releases/October-2017/Statement-from-Ohio-Attorney-General-
Mike-DeWine-F.
8
Health Resources & Servs. Administration, Why Use Telehealth? (updated Feb. 29, 2024),
https://telehealth.hhs.gov/patients/why-use-telehealth#what-are-the-benefits-of-telehealth.
9
Health Resources & Servs. Administration, Telehealth Policy Changes After the COVID-19 Public Health
Emergency (updated Dec. 19, 2023), https://telehealth.hhs.gov/providers/telehealth-policy/policy-changes-after-the-
covid-19-public-health-emergency.
24
473l.74(B)(1). They can also decide whether prescription of a controlled substance is appropriate
for a patient via telehealth under some circumstances. R.C. 473l.74(B)(2).
b. PPSWO and PPGOH’s Telemedicine Medication Abortion

Procedures
84. PPSWO and PPGOH strive to make their services as accessible as possible,
particularly for patients in underserved communities. Consistent with this mission, PPSWO and
PPGOH offer many services via telemedicine.
85. Before the introduction of TMAB, all Day 1 (in-person pre-abortion information)
and Day 2 (abortion provision) visits occurred at PPSWO and PPGOH’s ASFs in Cincinnati, East
Columbus, and Bedford Heights. As explained above, Plaintiffs cannot legally perform procedural
abortions anywhere other than those ASFs. See R.C. 3702.30(A)(l), (E)(l). And although state
law does not expressly bar the provision of medication abortion at non-ASFs, it provides that only
physicians may provide these abortions. Because PPSWO and PPGOH’s physicians are based at
ASFs, and they cannot feasibly be distributed to other health centers, patients obtaining medication
abortion from PPSWO and PPGOH traditionally had to complete their Day 2 visit at one of
PPSWO and PPGOH’s ASFs as well.
86. Starting in 2018 and 2019, respectively, PPGOH and PPSWO allowed some
qualified patients to have their second day medication abortion appointment via site-to-site
telemedicine. For administrative reasons, PPSWO and PPGOH have since discontinued this
practice, and both are piloting a new telemedicine practice that allows some qualified patients to
complete their second medication abortion appointment via telemedicine. After having their Day
1 appointment at one of the ASFs, patients in the TMAB pilot programs are provided with a
combination-coded secure lockbox containing their doses of mifepristone and misoprostol, as well
as nausea medication and ibuprofen to take home. After the required 24-hour waiting period has
25
passed, the patient can have their Day 2 appointment via telemedicine from their home or another
location of their choosing. During this appointment, the physician confirms the patient’s decision
to proceed, confirms the patient has not had a change in symptoms, answers any questions the
patients may have, and finally, gives the patient the combination code to the lockbox. The
physician then observes the patient ingesting the mifepristone. The patient then takes the
misoprostol 24 to 48 hours later.
87. PPGOH and PPSWO’s experiences with TMAB have been very positive. TMAB
services are equivalent in quality to those provided in-person on Day 2 at those clinics’ ASFs, and
for many patients, the TMAB option is superior in meeting their preferences and needs. The
TMAB process also helps reduce patients’ travel burden and related delays.
c. Impact of the Telemedicine Ban on Patients and Providers
88. If allowed to go into effect, the Telemedicine Ban would burden, penalize, interfere
with, and, in some cases, may prohibit patients’ exercise of their right to abortion, and providers’
efforts to assist them in doing so. Indeed, PPSWO, PPGOH, and Dr. Liner would be forced to
stop offering TMAB entirely.
89. The Telemedicine Ban also discriminates against abortion care compared to all
other forms of health care. For example, it does not affect the provision by telemedicine of
medication used to manage miscarriage, even though such medication is often identical to that
used for medication abortion.
90. The Telemedicine Ban also does nothing to advance patient health in accordance
with widely accepted and evidence-based standards of care. According to the National Academies
of Sciences, Engineering, and Medicine (“NASEM”), “There is no evidence that the dispensing or
taking of mifepristone tablets requires the physical presence of a clinician . . . to ensure safety or
quality. The effects of mifepristone occur after women leave the clinic, and extensive research
26
shows that serious complications are rare.”10 Similarly, the American College of Obstetricians
and Gynecologists (“ACOG”) has concluded that patients can “safely and effectively” use
mifepristone and misoprostol at home for medication abortion.11
91. Complications from medication abortion are exceedingly rare, and when such
complications arise, it would not matter whether the patient obtained a medication abortion in
person or through telemedicine because such events most commonly occur only after the patient
has taken the second medication, misoprostol, which occurs at least 24 hours after they have left
the clinic.
92. The Telemedicine Ban would force abortion patients in Ohio to make at least two
trips to the clinic. Forcing more abortion patients to make at least two separate visits to the clinic
for care imposes tangible burdens and costs on them and creates significant logistical barriers to
accessing time-sensitive abortion care.
93. As a result of the Telemedicine Ban, abortion patients who could have otherwise
made only one visit to the clinic would be forced to take more time off from work or away from
school, arrange and pay for additional child care, arrange and pay for additional transportation to
and from the clinic on different days, and/or find and pay for overnight accommodations near the
clinic, particularly for those traveling from further distances. In many cases, patients would have
to overcome all of these obstacles to return to the clinic simply so their physician can hand them
medication, which could have easily been provided in a secure lockbox at the initial appointment.
10
Nat’l Academies of Sciences, Eng. & Medicine, The Safety & Quality of Abortion Care in the United States 79
(2018).
11
ACOG, Medication Abortion Up to 70 Days of Gestation, Practice Bulletin No. 225 (Oct. 2020),
https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/10/medication-abortion-up-to-70-
days-of-
gestation#:~:text=Patients%20can%20safely%20and%20effectively,who%20undergo%20a%20medication%20abort
ion. ACOG is a professional membership organization for obstetrician–gynecologists.
27
94. These financial and logistical barriers would be particularly burdensome and
harmful for already vulnerable groups, including poor or low-income patients who constitute a
majority of people seeking abortion. These patients often have particular difficulty getting time
off work due to inflexible scheduling at low-wage jobs, and even if they are able to get days off,
they often work in jobs that do not provide paid leave and therefore may forgo wages for time
away from work. Low-income patients may also need to delay their second appointment to save
up enough money to afford the expense of additional child care and costs.
95. Patients whose access to abortion would be delayed by the Telemedicine Ban may
also suffer increased medical risks associated with delaying their abortion or continuing
pregnancy—because, as noted above, while abortion is very safe, its risks increase as pregnancy
progresses. And some patients may lose the ability to access medication abortion altogether if the
pregnancy extends beyond Ohio’s 70-day LMP limit.
96. The Telemedicine Ban may create barriers that, for some patients, will so delay
their access that they cannot have an abortion at all.
97. If allowed to go into effect, the Telemedicine Ban will cause irreparable harm to
both patients and to PPSWO, PPGOH, and Dr. Liner, who will be forced to stop providing
constitutionally protected health care to their patients and be threatened with criminal and civil
penalties.
98. In sum, the Telemedicine Ban burdens, penalizes, interferes with, discriminates
against and, in some cases, may prohibit patients’ voluntary exercise of their right to make and
carry out their own reproductive decisions, including the decision to obtain medication abortion,
and inhibits PPSWO, PPGOH, and Dr. Liner from assisting patients in exercising this right,
without any countervailing benefit to patient health.
28
2. APC Ban
99. The APC Ban prevents health care providers who are not physicians from providing
medication abortion. R.C. 2317.56(B), 2919.11, 2919.123, 4723.44(B)(6), 4723.50(B)(1),
4723.151(C), 4730.02(E), 4730.03(F), 4730.39(B)(2), 4730.42(A)(1); Ohio Adm.Code 4723-9-
10(K), 4730-2-07(E). Under Ohio law, advanced practice clinicians cannot prescribe “any drug
or device to perform or induce an abortion, or otherwise perform or induce an abortion.” R.C.
4723.44(B)(6) (advanced practice registered nurses (“APRNs” 12)), 4730.02(E) (PAs); see also
Ohio Adm.Code 4723-9-10(K) (APRNs), 4730-2-07(E) (PAs). Any APC who does so may be
subject to disciplinary action, including the revocation or suspension of their license to practice as
an APC. See R.C. 4623.28(B)(30) (APRNs); 4730.25(B)(24) (PAs). Ohio law further restricts
APCs by preventing any person from providing, selling, dispensing, or administering mifepristone
“for the purpose of inducing an abortion in any person or enabling the other person to induce an
abortion in any person,” unless that person is a physician. R.C. 2919.123(A).
100. Ohio law also provides that abortion constitutes the practice of medicine or surgery,
see R.C. 2919.11, and that medicine or surgery may only be practiced or performed by a person
licensed by the Medical Board, see R.C. 4731.41(A).
101. Lastly, as explained above, Ohio law requires the Day 1 mandatory, in-person
information session to be completed by a physician. See R.C. 2317.56(B)(1). Thus, APCs cannot
obtain informed consent from abortion patients. In conjunction, these provisions establish the
requirement that only physicians may provide abortions in Ohio.
102. The APC Ban burdens, penalizes, interferes with, and discriminates against
patients’ right to abortion, and prohibits APCs from assisting such patients by providing
12
NPs and CNMs are two types of APRNs.
29
medication abortions. But for the APC Ban, Plaintiffs would train currently employed APCs
and/or seek to hire APCs to provide medication abortions, expanding access to care.
a. APCs’ Scope of Practice in Ohio
103. APCs are health care professionals who have completed advanced education in a
specific area of health care. APCs include NPs, CNMs, and PAs. In Ohio, APCs’ scope of practice
is highly regulated. Even so, APCs are delegated broad authority by the Medical Board, in the
case of PAs, and the Nursing Board, in the case of NPs and CNMs.
104. APCs like Plaintiff Quinn are highly skilled and qualified clinicians who, based on
advanced education and training, have a broad scope of practice, including extensive prescriptive
authority and the ability to perform a range of complex medical procedures.
105. With appropriate education and training, APCs are highly qualified to provide
medication abortions.
106. Ohio APCs currently perform a variety of reproductive health interventions of
greater technical complexity that require more advanced skills than administering a medication
abortion. For example, consistent with their training and experience, APCs can insert and remove
intrauterine devices (“IUDs”) and contraceptive implants; and perform colposcopies.
107. APCs are subject to Ohio’s generally applicable professional licensure, health, and
tort laws and regulations. For instance, the Medical Board has the power to place PAs on
probation, impose sanctions or civil penalties, or suspend or revoke their licenses or prescriber
number for a variety of acts or conduct. R.C. 4730.25, 4730.252. The Nursing Board has the same
power to discipline NPs and CNMs. R.C. 4723.28.
108. APCs also face criminal penalties for violating the APC Ban. See R.C.
2919.123(E), 4723.99(A) (APRNs), 4730.99 (PAs).
30
i. Nurse Practitioners
109. NPs are regulated by the Nursing Board, and in order to practice, must be a
registered nurse, be certified by an approved national certification organization, hold a master’s or
higher degree in nursing or a related field, and have completed a graduate-level NP education
program. R.C. 4723.41, 4723.482(A)–(B). NPs are required to renew their license to practice
nursing every two years and complete continuing nursing education credits, of which at least
twelve hours must be in advanced pharmacology from an accredited institution. See R.C.
4723.24(A)(1)(c), (C)(2)(c).
110. NPs have a broad scope of practice by virtue of their advanced education and
training. Under Ohio law, NPs’ scope of practice includes performing medical procedures and
prescribing controlled substances, appropriate to their education and experience. R.C. 4723.43(C).
111. By virtue of their skill and competency, NPs are authorized under Ohio law to
practice with a high degree of independence, so long as they have entered into a standard care
arrangement with a primary supervising physician. See R.C. 4723.43, 4723.431; Ohio Adm.Code
4723-8-04. While physicians can enter into standard care arrangements with more than five
nurses, physicians cannot collaborate at the same time with over five nurses “in the prescribing
component[s] of their practices.” R.C. 4723.431(A)(1). Additionally, while the supervising
physician must be “continuously available to communicate” with the NP “either in person, or by
electronic communication,” the physician is not required to be physically present when the NP is
practicing. Ohio Adm.Code 4723-8-01(B)(1).
ii. Certified Nurse-Midwives
112. Like NPs, CNMs are regulated by the Nursing Board. In order to practice, CNMs
must obtain a master’s or doctoral degree with a major in nursing specialty or in a related field and
pass a national CNM certification examination. R.C. 4723.41(A). CNMs must renew their license
31
to practice nursing every two years and complete continuing nursing education credits, of which
at least twelve hours must be in advanced pharmacology from an accredited institution. R.C.
4723.24(A)(1)(c), (C)(2)(c).
113. It is within CNMs’ scope of practice in Ohio to manage preventive and primary
care services necessary to provide health care to women during pregnancy, labor, and birth, attend
to normal vaginal deliveries, and repair vaginal tears. As part of their practice, CNMs regularly
treat and monitor maternal risks, including vaginal tears, postpartum hemorrhage, and more—all
of which are routine and carry higher risks to patient health than the risks associated with
medication abortion.
114. Ohio statutes expressly permit CNMs to prescribe medications, attend patients in
uncomplicated labor, and perform procedures associated with childbirth (i.e., episiotomies and
repair of vaginal tearing). R.C. 4723.43(A). In emergencies, CNMs can “perform version, deliver
breech or face presentation, use forceps, do any obstetric operation, or treat any other abnormal
condition.” Id.
115. By virtue of their skill and competency, CNMs are authorized under Ohio law to
practice with a high degree of independence, so long as they have entered into a standard care
agreement with a primary supervising physician. Ohio Adm.Code 4723-8-04. Although
physicians may enter in standard care arrangements with more than five nurses, they are limited
to collaborating with no more than five nurses at the same time “in the prescribing component[s]
of their practices.” R.C. 4723.431(A)(1). Additionally, while the primary or back-up supervising
physician must be “continuously available to communicate” with the CNM “either in person, or
by electronic communication,” the physician is not required to be physically present when the
CNM is practicing. Ohio Adm.Code 4723-8-01(B)(2).
32
iii. Physician Assistants
116. PAs are regulated by the Medical Board, must be licensed, must generally complete
a master’s or higher degree from an accredited organization or program, and must complete 12
hours of continuing medical education every two years. R.C. 4730.11, 4730.14, 4730.49(A)(1).
117. A PA may perform “services authorized by the supervising physician” that are
within the “supervising physician’s normal course of practice and expertise.” R.C. 4730.20(A).
118. PAs can also see patients in ways similar to physicians. Within their scope of
practice, and consistent with their training and qualifications, PAs can perform comprehensive
physical exams, order and interpret diagnostic tests, diagnose and initiate treatment, assist
physicians in surgery, and perform bedside procedures, among other forms of care.
119. By virtue of their skill and competency, PAs are authorized by Ohio law to practice
with a high degree of independence, so long as they practice under a “supervising physician.” R.C.
4730.02. As in the case of NPs and CNMs, this does not require the supervising physician’s
physical presence, provided the physician is “continuously available for direct communication”
with the PA through other means. R.C. 4730.21(A)(1). Physicians are not allowed to supervise
over five PAs at a time, but a PA may enter into supervision agreements “with any number of
supervising physicians.” R.C. 4730.21(B).
120. PAs can order, prescribe, personally furnish, and administer drugs and medical
devices, including controlled substances, so long as the PA “holds a valid prescriber number issued
by the Medical Board and has been granted physician-delegated prescriptive authority.” R.C.
4730.20(A)(7), 4730.41.
b. Ohio Law Bars APCs from Providing Medication Abortions

Even When Doing So Would Be Within Their Scope of Practice
33
121. Ohio law prohibits APCs from providing medication abortion despite their
qualifications, training, and experience. The APC Ban is out of step with Ohio’s scope of practice
regulations, as evidenced by the fact that APCs may legally provide the same medications used in
medication abortion—mifepristone and misoprostol—for other purposes, such as miscarriage
management. There is no medical basis for prohibiting APCs from prescribing and overseeing the
use of these same medications for a medication abortion, consistent with their training and
experience.
122. Preventing APCs from prescribing certain medications solely in the abortion
context is particularly burdensome and discriminatory, as Ohio law does not categorically prevent
APCs from handling pre- and post-medication abortion patient care. APCs may, for example,
perform an ultrasound, pregnancy test, and/or other lab tests for the patient. In addition, APCs are
trained to recognize circumstances when they would need to refer a patient to a physician, should
the patient need a higher level of care.
c. Evidence Demonstrates APCs Can Safely and Effectively

Provide Medication Abortion
123. There is no medical basis for the APC Ban, because widely accepted, evidence-
based standards of care support appropriately trained APCs providing medication abortion.
124. APCs are capable of providing medication abortion safely and effectively.
NASEM concluded in their 2018 consensus report that “[b]oth trained physicians . . . and APCs
(physician assistants, certified nurse-midwives, and nurse practitioners) can provide medication .
. . abortions safely and effectively,” citing an “extensive body of research documenting the safety
of abortion care in the United States.”13
13
Nat’l Academies of Sciences, Eng. & Medicine, The Safety & Quality of Abortion Care in the United States 14
(2018).
34
125. Leading medical authorities, including ACOG, the American Public Health
Association, the World Health Organization, and Physicians for Reproductive Health have
concluded that laws prohibiting qualified APCs from providing medication abortion services
prevent access to safe abortion care.
126. Indeed, the FDA has contemplated APC prescription of mifepristone since its
approval in 2000. The 2000 label allowed APCs to prescribe mifepristone without a physician’s
physical presence, provided the APC was supervised by a physician. The 2016 label removed all
restrictions on APC prescription, allowing them to prescribe mifepristone fully independently.
127. Of the states in which abortion is legal, twenty-one states and the District of
Columbia allow APCs to provide medication abortion care.
128. PPSWO currently employs APCs, including NPs and CNMs. PPSWO would train
its current APCs to provide medication abortion, and seek to hire additional APCs as needed, if
APCs were permitted to provide medication abortion.
129. PPGOH currently employs APCs, including NPs. PPGOH would train its current
APCs to provide medication abortion if APCs were permitted to do so.
130. WMD and Preterm are not currently staffed with APCs but would seek to hire and
train APCs to provide medication abortion if APCs were permitted to do so.
131. But for the APC Ban, APC provision of medication abortion at PPSWO, PPGOH,
WMD, and Preterm would further expand services to meet patient need.
132. APCs at PPSWO and PPGOH, including Plaintiff Quinn, perform procedures,
including IUD and contraceptive implants insertion and removal, that are either comparable in
complexity and risk to medication abortion, or are even more complex and risky than medication
abortion.
35
133. APCs at PPSWO and PPGOH, including Plaintiff Quinn, are highly qualified and
trained clinicians who, but for the APC Ban, would be trained to provide safe medication abortion
care through the appropriate collaborative practice and supervisory arrangements with physicians.
d. The APC Ban Harms Patients and Providers
134. By unnecessarily limiting the pool of available medication abortion providers in
Ohio, the APC Ban significantly restricts and delays access to abortion and contradicts widely
accepted and evidence-based standards of care, thereby jeopardizing (rather than advancing)
patient health and safety and imposing significant financial and logistical burdens on clinics and
patients.
135. The APC Ban burdens, penalizes, discriminates against, and interferes with
Ohioans’ fundamental constitutional right to abortion because it subjects medication abortion
patients to unnecessary delays in accessing care, which increases risks to patient health and adds
to the financial and logistical burdens of obtaining an abortion.
136. The APC Ban also burdens, penalizes, discriminates against, and interferes with
providers’ ability to assist Ohioans seeking to exercise this fundamental right to make reproductive
decisions. APCs are expressly prohibited from providing medication abortions, forcing patients
to rely on physicians at ASFs and effectively limiting the number of patients that can access
medication abortions.
137. There is a nationwide shortage of reproductive health care providers, and Ohio is
no exception. But for the APC Ban, Plaintiffs could expand the pool of qualified professionals
able to provide medication abortion care in Ohio to include APCs. This would mean Ohioans
would have a larger pool of providers and availability of appointments from which to obtain
medication abortion care, increasing schedule flexibility for both Plaintiffs and their patients and
reducing delays and travel burdens.
36
138. Having a limited pool of medication abortion providers does not advance patient
health and instead causes medically unnecessary delays that may harm patients’ health in a number
of ways. Delays subject patients to the risks associated with pregnancy for a longer period of time
and force patients to obtain care later in pregnancy, which increases the associated risks of an
abortion, despite its overall safety. In some cases, delaying access to care can push a patient past
the point in pregnancy when medication abortion is available.
139. But for the APC Ban, PPSWO and PPGOH could provide medication abortion at
their non-ASF health centers, rather than just at their ASFs, and WMD would open a new clinic
with APCs on staff in the greater Cincinnati area. This would reduce the distance traveled by some
patients to receive medication abortion care.
140. But for the APC Ban, the Plaintiff clinics could hire and train APCs to provide
medication abortion care, expanding access.
141. In sum, the APC Ban burdens, penalizes, interferes with, discriminates against and,
in some cases, may prohibit patients’ voluntary exercise of their right to make and carry out their
own reproductive decisions, including the decision to obtain medication abortion, and inhibits
Plaintiffs from assisting patients in exercising this right, without any countervailing benefit to
patient health.
3. Evidence-Based Use Ban
142. The Evidence-Based Use Ban restricts the use of mifepristone solely for abortion
care, despite best medical evidence, by mandating that providers use the drug for abortion only in
accordance with the FDA’s final printed label. This prohibition on other uses of mifepristone not
expressly included in the label, also known as “evidence based” or “off-label use,” burdens,
penalizes, interferes with, discriminates against and, in some cases, may prohibit patients’ access
to abortion and inhibits Plaintiffs from assisting patients in exercising their right to abortion.
37
143. In 2004, the Ohio General Assembly enacted R.C. 2919.123—the Evidence-Based
Use Ban—a first-of-its-kind restriction on the off-label use of mifepristone.
144. The Evidence-Based Use Ban criminalizes providing mifepristone for abortion care
except “in accordance with all provisions of federal law that govern the use of RU-486
(mifepristone) for inducing abortions.” R.C. 2919.123(A), 2919.123(F)(1).
145. The Supreme Court of Ohio has interpreted the Evidence-Based Use Ban to mean
that a physician providing mifepristone for the purpose of inducing an abortion may do so “only
by using the dosage indications and treatment protocols expressly approved by the FDA in the
drug’s final printed labeling as incorporated by the drug approval letter.” Cordray v. Planned
Parenthood Cincinnati Region, 122 Ohio St.3d 361, 2009-Ohio-2972, 911 N.E.2d 871, ¶ 35 (Ohio
2009).
146. The FDA’s approved drug regimen is the result of a lengthy review process. In
order to obtain FDA approval to market a drug product in the United States, a manufacturer
submits an application containing evidence that the drug is safe and effective for its intended use.
If the FDA determines that the drug’s health benefits outweigh its known risks for that particular
use, the FDA approves the drug for sale along with its proposed label.
147. To ensure the drug’s benefits outweigh its risks, the FDA may require a Risk
Evaluation and Mitigation Strategy (“REMS”). 21 U.S.C. § 355-1(a)(1). In 2011, the FDA
approved a REMS for mifepristone that incorporated the same conditions of use the agency had
imposed when first approving mifepristone in 2000.14 Despite the proven safety of mifepristone
14
The FDA implemented restrictions for mifepristone when first approving its use, under a provision then known as
“subpart H,” 21 C.F.R. §§ 314.500–560, and later under a REMS.
38
in the two decades since its approval, and despite broad calls from the medical community to
eliminate it based on mifepristone’s safety record, FDA has kept a REMS in place.15
148. The current FDA-approved mifepristone regimen, which was established in 2016,
includes 200 mg of mifepristone taken orally, followed 24 to 48 hours later by 800 µg of
misoprostol taken buccally, through 70 days LMP.
149. If a provider prescribes mifepristone to terminate a pregnancy in a way that differs
from this regimen—in other words, if they prescribe mifepristone “off-label”—they are “guilty of
unlawful distribution of an abortion-inducing drug, a felony of the fourth degree” under Ohio law,
and also subjected to administrative penalties, including revocation of professional licenses. R.C.
2919.123(E). For a second violation, the provider is guilty of a felony in the third degree. Id.
a. Evolution and Benefits of Off-Label Use
150. Off-label use of medications pursuant to evidence-based protocols is an essential
part of medical practice. In clinical practice, new uses or dosing regimens often become widely
adopted and well accepted long before they are reflected in the drug’s final printed labeling. Off-
label protocols are supported by evidence-based medical practices and providers’ exercise of their
professional judgment in caring for their patients.
151. Examples of common off-label protocols abound and include prescribing aspirin to
prevent heart attacks, Wellbutrin, approved by the FDA as an antidepressant, for smoking
cessation, laxatives for children with constipation,16 and Lidocaine to treat complications from
shingles.17
15
On March 29, 2016, the FDA approved changes to mifepristone’s label, including its REMS.
16
Divya Hoon et al., Trends in Off-Label Drug Use in Ambulatory Settings: 2006-2015, 144(4) Pediatrics, 5-6 (2019).
Christopher M. Wittich et al., Ten Common Questions (and Their Answers) About Off-Label Drug Use, 87(10)
17
Mayo Clinic Proc. 982 (2012).
39
152. Ohio does not restrict off-label use of the vast majority of drugs. Upon information
and belief, such restrictions are only in effect for mifepristone for abortion and certain Schedule
III anabolic steroids, see R.C. 3719.06(B), which exhibit significantly higher rates of adverse
effects than mifepristone.
153. In Ohio, off-label protocols are even protected in certain areas. For example, as
long as a drug has been recognized as safe and effective for treatment, R.C. 1751.66(A) prohibits
insurance providers from “exclud[ing] coverage for any drug approved by the [FDA] on the basis
that the drug has not been approved by the [FDA] for the treatment of the particular indication for
which the drug has been prescribed.”
154. The Evidence-Based Use Ban singles out patients and abortion providers using
mifepristone for abortion care for differential and unfavorable treatment because Ohio law does
not impose similar restrictions on the off-label use of mifepristone for other purposes, including
miscarriage management.
155. Mifepristone is a case in point of how off-label use can become the standard of
medical care well before the FDA formally approves the protocol.
156. The FDA originally approved mifepristone for use in the United States for abortion
care in 2000 using 600 mg of mifepristone, followed two days later by 400 µg of misoprostol,
through 49 days LMP.
157. Even before the FDA’s approval of mifepristone, newer research had been
conducted showing that a lower dosage (200 mg) of mifepristone combined with a different dosage
and manner of administering misoprostol was equally safe and effective through 63 days LMP.
This research also showed that reducing the mifepristone dose decreased side effects. As a result,
for almost two decades after mifepristone was first approved for use by the FDA, the regimen most
40
commonly used across the country was a regimen that differed from that detailed in the approved
label at the time.
158. In 2016, the FDA approved several changes to mifepristone’s label, including its
REMS, expressly relying on this evidence-based regimen, which had become the standard of care
in clinical practice. This update resulted in the current label outlining a regimen of 200 mg of
mifepristone taken orally, followed 24 to 48 hours later by 800 µg of misoprostol taken buccally,
through 70 days LMP.
159. Additional safe, validated off-label uses of mifepristone have made, and will likely
continue to make, abortion safer and more accessible.
160. For example, subsequent research shows that a regimen of mifepristone and
misoprostol is safe and effective beyond 70 days LMP.18
161. The Evidence-Based Use Ban also restricts the prescription of misoprostol when it
is prescribed as part of a medication abortion regimen that includes mifepristone. For example,
while some patients prefer to take misoprostol orally or vaginally, the FDA label specifies that it
should be taken buccally, so providers cannot employ these alternative routes of administration for
misoprostol when the drug is being used in tandem with mifepristone for abortion, even though
they have been shown to be safe and effective.
b. The Evidence-Based Use Ban’s Impact on Patients and

Providers
18
See, e.g., Ilana G. Dzuba et al., A Repeat Dose of Misoprostol 800 mcg Following Mifepristone for Outpatient
Medical Abortion at 64–70 and 71–77 Days of Gestation: A Retrospective Chart Review, 102(2) Contraception 104,
106 (2020); Nathalie Kapp et al., Medical Abortion in the Late First Trimester: A Systematic Review, 99(2)
Contraception 77, 77–86 (Feb. 2019).
41
162. By prohibiting off-label uses of mifepristone for abortion care, the Evidence-Based
Use Ban violates Ohioans’ right to make and carry out their own reproductive decisions and
interferes with Plaintiffs’ ability to assist them in doing so.
163. For many patients, including some of Plaintiffs’ patients, an evidence-based, off-
label mifepristone regimen is the safest and most effective way to obtain an abortion. Many
patients also strongly prefer medication abortions over procedural abortions.
164. Prohibiting off-label use of mifepristone for abortion care impedes access by,
among other things, prohibiting these patients from obtaining medication abortion, exacerbating
the psychological and emotional toll for those who find a more invasive procedural abortion to be
uncomfortable or traumatic; and erecting barriers in the form of travel and its associated costs,
such as lost wages and expenses for child care, transportation, and accommodations.
165. Further, patients who are otherwise unable to undergo a procedural abortion,
whether because of medical indications, trauma, or concerns around bodily control, are left either
to attempt to travel out of state to access medication abortion, obtain a medication abortion outside
the medical system, or in some cases, potentially even to carry an unwanted pregnancy to term.19
166. But for the Evidence-Based Use Ban, Plaintiffs would prescribe mifepristone for
the termination of pregnancies beyond 70 days LMP based on the best available medical evidence.
167. As research continues to progress, additional validated, effective off-label uses of
mifepristone for abortion care may be identified, which will continue to make abortion safer and
more accessible. But, by prohibiting off-label use of mifepristone for abortions, the Evidence-
Based Use Ban prevents patients from benefiting from such advances.
19
These harms are only exacerbated by the Day 1 and Day 2 visit requirement because the delays resulting from that
requirement can push a patient beyond 70 days LMP before the patient is able to access medication abortion
services. See supra ¶¶ 69–70.
42
168. Restricting off-label use of mifepristone for abortions does not advance patient
health in accordance with widely accepted and evidenced-based standards of care. To the contrary,
it risks harming patient health by restricting Plaintiffs’ discretion to use the most appropriate,
safest, and evidenced-based treatment for their patients and thereby preventing some patients from
obtaining their preferred method of abortion; delaying their care while they attempt to travel out
of state for medication abortion; or putting them in the position of having to try to obtain a
medication abortion outside the medical system or carry an unwanted pregnancy to term.
169. As demonstrated through historical practice and clinical research, evidence-based,
off-label protocols for mifepristone are safe and effective, and providers outside of Ohio routinely
prescribe mifepristone, as with many drugs, off-label in accordance with evidence-based standards
of care, their best medical judgment, and patients’ wishes and best interest.
170. The Evidence-Based Use Ban’s discriminatory nature and failure to advance patient
health is further evidenced by the law’s selective restrictions on mifepristone “for the purpose of
inducing an abortion” without comparable restrictions on mifepristone in other contexts, including
for managing miscarriages. There is simply no medical justification for restricting one and not the
other.
171. In sum, the Evidence-Based Use Ban burdens, penalizes, interferes with,
discriminates against and, in some cases, may prohibit patients’ voluntary exercise of their right
to make and carry out their own reproductive decisions, including the decision to obtain medication
abortion, and inhibits Plaintiffs from assisting patients in exercising this right, without any
countervailing benefit to patient health.
43
CLAIMS FOR RELIEF
COUNT I – Right to Reproductive Freedom
172. Plaintiffs reallege and incorporate by reference the allegations contained in
paragraphs 1 through 171.
173. Under the Ohio Constitution, “[e]very individual has a right to make and carry out
one’s own reproductive decisions” including the decision to obtain an abortion, and the State “shall
not, directly or indirectly, burden, penalize, prohibit, interfere with, or discriminate against” any
“individual’s voluntary exercise of” the right to abortion, or “a person or entity that assists an
individual exercising this right, unless the State demonstrates that it is using the least restrictive
means to advance the individual’s health in accordance with widely accepted and evidence-based
standards of care.” Ohio Constitution, Article I, Sections 22(A)–(B).
174. The Challenged Laws impose onerous and unnecessary requirements that delay,
impede, and, in some cases, may prevent access to abortion, create financial and logistical
obstacles to obtaining an abortion, undermine patient self-determination, and discriminate against
abortion patients and providers, singling them out for differential and unfavorable treatment. In
doing so, the Challenged Laws—the Telemedicine Ban20, the APC Ban, and the Evidence-Based
Use Ban—each individually and in combination, directly and indirectly burden, penalize, prohibit,
interfere with, and discriminate against both Ohioans’ right to make and carry out the decision to
have an abortion, including a medication abortion, and Plaintiffs in assisting their patients in
exercising that right.
175. The Challenged Laws are not “the least restrictive means to advance the
individual’s health in accordance with widely accepted and evidence-based standards of care.”
20
WMD and Preterm are not challenging the Telemedicine Ban.
44
The Challenged Laws have no legitimate medical justification, contradict evidence-based best
medical practice, the standard of care, and mainstream medical consensus, and serve only to harm
patients’ health and well-being.
176. Accordingly, the Challenged Laws violate Article I, Section 22 of the Ohio
Constitution.
177. Plaintiffs and their patients have no adequate remedy at law to address these harms.
COUNT II – Substantive Due Process
178. PPGOH, PPSWO, and Dr. Liner reallege and incorporate by reference the
allegations contained in paragraphs 1 through 171.
179. By prohibiting access to safe and effective TMAB, the Telemedicine Ban infringes
on the right to pre-viability abortion, privacy, bodily autonomy, and free choice of health care
guaranteed under the Ohio Constitution, Article I, Sections 1, 2, 16, and 20, without adequate
justification.
180. If the Telemedicine Ban is allowed to take effect, PPGOH, PPSWO, and Dr. Liner
and their patients will be unable to offer and use TMAB in Ohio, thereby causing them to suffer
significant constitutional, medical, emotional, financial, and other harm. PPGOH, PPSWO, and
Dr. Liner have no adequate remedy at law to address these harms.
COUNT III – Patients’ Equal Protection
182. The Telemedicine Ban denies PPGOH, PPSWO, and Dr. Liner’s patients their right
to the enjoyment of equal protection and benefit under the Ohio Constitution, Article I, Section 2,
by singling out medication abortion for worse treatment than comparable types of health care freely
45
offered via telemedicine, including forms of health care sought by men, without adequate
justification.
183. If the Telemedicine Ban is allowed to take effect, PPGOH, PPSWO, and Dr. Liner’s
patients will be deprived of equal protection of the laws under the Ohio Constitution, thereby
causing them to suffer significant constitutional, medical, emotional, financial, and other harm.
PPGOH, PPSWO, and Dr. Liner have no adequate remedy at law to address these harms.
COUNT IV – Abortion Providers’ Equal Protection
185. The Telemedicine Ban denies PPGOH, PPSWO, and Dr. Liner their right to the
enjoyment of equal protection and benefit under the Ohio Constitution, Article I, Section 2, by
targeting abortion providers with criminal penalties and professional sanctions for providing
medication abortion using telemedicine, while leaving unrestricted other medical providers,
including those who treat miscarriage using the exact same medications as in medication abortion,
without adequate justification.
186. If the Telemedicine Ban is allowed to take effect, PPGOH, PPSWO, and Dr. Liner
will be subject to irreparable harm by depriving them of equal protection of the laws under the
Ohio Constitution, thereby causing them to suffer significant constitutional, business, and
professional harm and threatening them with civil and criminal penalties. PPGOH, PPSWO, and
Dr. Liner have no adequate remedy at law to address these harms.
COUNT V – Declaratory Judgment
187. Plaintiffs reallege and incorporate by reference the allegations contained in
paragraphs 1 through 171.
46
188. A real controversy exists between the parties, the controversy is justiciable, and
speedy relief is necessary to preserve the rights of the parties. Plaintiffs and their patients are
adversely affected by the Challenged Laws, as set forth herein.
189. The rights, status, and other legal relations of Plaintiffs are uncertain and insecure,
and the entry of a declaratory judgment by this Court will terminate the uncertainty and
controversy that has given rise to the action.
190. Pursuant to R.C. 2721.01, et seq., Plaintiffs request that the Court find and issue a
declaration that:
a. The Challenged Laws violate Article I, Section 22 of the Ohio Constitution
because they burden, penalize, prohibit, interfere with, and discriminate against Ohioans in
exercising their constitutional right to abortion and those who assist them in doing so;
b. The Telemedicine Ban violates Article I, Sections 1, 2, 16, and 20 of the
Ohio Constitution by denying PPGOH, PPSWO, and Dr. Liner and their patients substantive due
process rights to previability abortion, privacy, bodily autonomy, and free choice in health care;
c. The Telemedicine Ban violates Article I, Section 2 of the Ohio Constitution
by denying PPGOH, PPSWO, and Dr. Liner’s patients the equal protection and benefit of the law,
in that it singles out medication abortion via telemedicine from all other comparable forms of care,
including care obtained by men and miscarriage management, without adequate justification; and
d. The Telemedicine Ban violates Article I, Section 2 of the Ohio Constitution
by denying PPGOH, PPSWO, and Dr. Liner the equal protection and benefit of the law, in that it
singles out abortion providers for criminal and civil sanctions while leaving unregulated other
health care providers offering comparable services without adequate justification.
47
REQUEST FOR RELIEF
WHEREFORE, Plaintiffs ask this Court:
A. To immediately issue a preliminary injunction, and later a permanent injunction,
restraining Defendants, their employees, agents, servants, and successors, and any
persons in active concert or participation with them, from enforcing the APC Ban
(R.C. 2317.56(B), 2919.11, 2919.123, 4723.44(B)(6), 4723.50(B)(1), 4723.151(C),
4730.02(E), 4730.03(F), 4730.39(B)(2), 4730.42(A)(1); Ohio Adm.Code 4723-9-
10(K), 4730-2-07(E)), the Evidence-Based Use Ban (R.C. 2919.123), and any other
Ohio statute or regulation that could be understood to give effect to those
provisions, including through any future enforcement actions based on conduct that
occurred during the pendency of an injunction;
B. To keep in place the preliminary injunction, and later enter a permanent injunction
restraining Defendants, their employees, agents, servants and successors, and any
persons in active concert or participation with them, from enforcing the
Telemedicine Ban (R.C. 2919.124), and any other Ohio statute or regulation that
could be understood to give effect to that provision, including through any future
enforcement actions based on conduct that occurred during the pendency of an
injunction; and
C. To grant such other and further relief as the Court deems just and proper.
48
Respectfully submitted,
/s/__Michelle Nicole Diamond______ B. Jessie Hill (0074770)

Michelle Nicole Diamond (Pro Hac Vice) Margaret Light-Scotece (0096030)
Peter Neiman (Pro Hac Vice) Freda J. Levenson (0045916)
Maura Douglas (Pro Hac Vice) ACLU of Ohio Foundation
Meghan Koushik (Pro Hac Vice) 4506 Chester Ave.
Zach Blair (Pro Hac Vice) Cleveland, OH 44103
Nicole Castillo (Pro Hac Vice) (216) 368-0553
WilmerHale LLP (614) 586-1974 (fax)
7 World Trade Center bjh11@cwru.edu
New York, NY 10007 margaret.light-scotece@case.edu
(212) 230-8800 flevenson@acluohio.org
michelle.diamond@wilmerhale.com Counsel for Preterm-Cleveland and
peter.neiman@wilmerhale.com Women’s Med Group Professional
Counsel for Plaintiffs Corporation
Alyssa Milstead (Pro Hac Vice) David J. Carey (0088787)

WilmerHale LLP ACLU of Ohio Foundation
2600 El Camino Real, Suite 400 1108 City Park Ave., Ste. 203
Palo Alto, CA 94306 Columbus, OH 43206
(650) 858-6000 (380) 215-0997
alyssa.milstead@wilmerhale.com
dcarey@acluohio.org
Counsel for Plaintiffs
Counsel for Preterm-Cleveland and
Women’s Med Group Professional
Catherine Humphreville (Pro Hac Vice)
Vanessa Pai-Thompson (Pro Hac Vice) Corporation
Planned Parenthood Federation of America
123 William Street, 9th Floor Meagan Burrows*
New York, NY 10038 Johanna Zacarias*
(212) 541-7800 (Pai-Thompson) American Civil Liberties Union
(212) 247-6811 (fax) 125 Broad St., 18th Fl.
catherine.humphreville@ppfa.org New York, NY 10004
vanessa.pai-thompson@ppfa.org (212)-549-2601
Counsel for Planned Parenthood mburrows@aclu.org
Southwest Ohio Region, Sharon Liner, jzacarias@aclu.org
Counsel for Preterm-Cleveland and
M.D., Julia Quinn, and Planned
Women’s Med Group Professional
Parenthood of Greater Ohio
Corporation
Fanon A. Rucker #0066880

The Cochran Firm
527 Linton Street
(513) 381-4878
49
(513) 672-0814 (fax)
frucker@cochranohio.com
Counsel for Planned Parenthood
Southwest Ohio Region, Sharon Liner,
M.D., Julia Quinn, and Planned
Parenthood of Greater Ohio
*Motion for pro hac vice forthcoming
Dated: May 9, 2024
50
Exhibit 2

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Exhibit 3
(133rd General Assembly)
(Senate Bill Number 260)
AN ACT
To amend sections 109.572, 2919.123, 2953.25, 4729.291, 4731.22, and 4731.223
and to enact section 2919.124 of the Revised Code regarding abortion-inducing
drugs.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1. That sections 109.572, 2919.123, 2953.25, 4729.291, 4731.22, and 4731.223 be
amended and section 2919.124 of the Revised Code be enacted to read as follows:
Sec. 109.572. (A)(1) Upon receipt of a request pursuant to section 121.08, 3301.32,
3301.541, or 3319.39 of the Revised Code, a completed form prescribed pursuant to division (C)(1)
of this section, and a set of fingerprint impressions obtained in the manner described in division (C)
(2) of this section, the superintendent of the bureau of criminal identification and investigation shall
conduct a criminal records check in the manner described in division (B) of this section to determine
whether any information exists that indicates that the person who is the subject of the request
previously has been convicted of or pleaded guilty to any of the following:
(a) A violation of section 2903.01, 2903.02, 2903.03, 2903.04, 2903.11, 2903.12, 2903.13,
2903.16, 2903.21, 2903.34, 2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04, 2907.05,
2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23, 2907.25, 2907.31, 2907.32,
2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12, 2919.22, 2919.24,
2919.25, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.04, 2925.05, 2925.06, or 3716.11 of
the Revised Code, felonious sexual penetration in violation of former section 2907.12 of the Revised
Code, a violation of section 2905.04 of the Revised Code as it existed prior to July 1, 1996, a
violation of section 2919.23 of the Revised Code that would have been a violation of section 2905.04
of the Revised Code as it existed prior to July 1, 1996, had the violation been committed prior to that
date, or a violation of section 2925.11 of the Revised Code that is not a minor drug possession
offense;
(b) A violation of an existing or former law of this state, any other state, or the United States
that is substantially equivalent to any of the offenses listed in division (A)(1)(a) of this section;
(c) If the request is made pursuant to section 3319.39 of the Revised Code for an applicant
who is a teacher, any offense specified in section 3319.31 of the Revised Code.
(2) On receipt of a request pursuant to section 3712.09 or 3721.121 of the Revised Code, a
completed form prescribed pursuant to division (C)(1) of this section, and a set of fingerprint
impressions obtained in the manner described in division (C)(2) of this section, the superintendent of
the bureau of criminal identification and investigation shall conduct a criminal records check with
respect to any person who has applied for employment in a position for which a criminal records
check is required by those sections. The superintendent shall conduct the criminal records check in
S. B. No. 260 133rd G.A.
2
the manner described in division (B) of this section to determine whether any information exists that
indicates that the person who is the subject of the request previously has been convicted of or pleaded
guilty to any of the following:
2903.16, 2903.21, 2903.34, 2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322,
2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11,
2913.21, 2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 2923.12, 2923.13,
2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 2925.22, 2925.23, or 3716.11 of the Revised Code;
(b) An existing or former law of this state, any other state, or the United States that is
substantially equivalent to any of the offenses listed in division (A)(2)(a) of this section.
(3) On receipt of a request pursuant to section 173.27, 173.38, 173.381, 3701.881, 5119.34,
5164.34, 5164.341, 5164.342, 5123.081, or 5123.169 of the Revised Code, a completed form
prescribed pursuant to division (C)(1) of this section, and a set of fingerprint impressions obtained in
the manner described in division (C)(2) of this section, the superintendent of the bureau of criminal
identification and investigation shall conduct a criminal records check of the person for whom the
request is made. The superintendent shall conduct the criminal records check in the manner described
in division (B) of this section to determine whether any information exists that indicates that the
person who is the subject of the request previously has been convicted of, has pleaded guilty to, or
(except in the case of a request pursuant to section 5164.34, 5164.341, or 5164.342 of the Revised
Code) has been found eligible for intervention in lieu of conviction for any of the following,
regardless of the date of the conviction, the date of entry of the guilty plea, or (except in the case of a
request pursuant to section 5164.34, 5164.341, or 5164.342 of the Revised Code) the date the person
was found eligible for intervention in lieu of conviction:
2903.11, 2903.12, 2903.13, 2903.15, 2903.16, 2903.21, 2903.211, 2903.22, 2903.34, 2903.341,
2905.01, 2905.02, 2905.05, 2905.11, 2905.12, 2905.32, 2905.33, 2907.02, 2907.03, 2907.04,
2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23, 2907.24, 2907.25,
2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2907.33, 2909.02, 2909.03, 2909.04, 2909.22,
2909.23, 2909.24, 2911.01, 2911.02, 2911.11, 2911.12, 2911.13, 2913.02, 2913.03, 2913.04,
2913.05, 2913.11, 2913.21, 2913.31, 2913.32, 2913.40, 2913.41, 2913.42, 2913.43, 2913.44,
2913.441, 2913.45, 2913.46, 2913.47, 2913.48, 2913.49, 2913.51, 2917.01, 2917.02, 2917.03,
2917.31, 2919.12, 2919.121, 2919.123, 2919.124, 2919.22, 2919.23, 2919.24, 2919.25, 2921.03,
2921.11, 2921.12, 2921.13, 2921.21, 2921.24, 2921.32, 2921.321, 2921.34, 2921.35, 2921.36,
2921.51, 2923.12, 2923.122, 2923.123, 2923.13, 2923.161, 2923.162, 2923.21, 2923.32, 2923.42,
2925.02, 2925.03, 2925.04, 2925.041, 2925.05, 2925.06, 2925.09, 2925.11, 2925.13, 2925.14,
2925.141, 2925.22, 2925.23, 2925.24, 2925.36, 2925.55, 2925.56, 2927.12, or 3716.11 of the
Revised Code;
(b) Felonious sexual penetration in violation of former section 2907.12 of the Revised Code;
(c) A violation of section 2905.04 of the Revised Code as it existed prior to July 1, 1996;
(d) A violation of section 2923.01, 2923.02, or 2923.03 of the Revised Code when the
underlying offense that is the object of the conspiracy, attempt, or complicity is one of the offenses
S. B. No. 260 133rd G.A.
3
listed in divisions (A)(3)(a) to (c) of this section;
(e) A violation of an existing or former municipal ordinance or law of this state, any other
state, or the United States that is substantially equivalent to any of the offenses listed in divisions (A)
(3)(a) to (d) of this section.
the bureau of criminal identification and investigation shall conduct a criminal records check in the
manner described in division (B) of this section to determine whether any information exists that
indicates that the person who is the subject of the request previously has been convicted of or pleaded
guilty to any of the following:
2903.13, 2903.15, 2903.16, 2903.21, 2903.211, 2903.22, 2903.34, 2905.01, 2905.02, 2905.05,
2907.02, 2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22,
2907.23, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2909.02, 2909.03, 2909.22,
2909.23, 2909.24, 2911.01, 2911.02, 2911.11, 2911.12, 2913.49, 2917.01, 2917.02, 2919.12,
2919.22, 2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.04, 2925.05,
2925.06, 2927.12, or 3716.11 of the Revised Code, a violation of section 2905.04 of the Revised
Code as it existed prior to July 1, 1996, a violation of section 2919.23 of the Revised Code that
would have been a violation of section 2905.04 of the Revised Code as it existed prior to July 1,
1996, had the violation been committed prior to that date, a violation of section 2925.11 of the
Revised Code that is not a minor drug possession offense, two or more OVI or OVUAC violations
committed within the three years immediately preceding the submission of the application or petition
that is the basis of the request, or felonious sexual penetration in violation of former section 2907.12
of the Revised Code;
that is substantially equivalent to any of the offenses listed in division (A)(4)(a) of this section.
(5) Upon receipt of a request pursuant to section 5104.013 of the Revised Code, a completed
form prescribed pursuant to division (C)(1) of this section, and a set of fingerprint impressions
obtained in the manner described in division (C)(2) of this section, the superintendent of the bureau
of criminal identification and investigation shall conduct a criminal records check in the manner
described in division (B) of this section to determine whether any information exists that indicates
that the person who is the subject of the request has been convicted of or pleaded guilty to any of the
following:
2903.13, 2903.16, 2903.21, 2903.22, 2903.34, 2905.01, 2905.02, 2905.05, 2905.11, 2905.32,
2907.02, 2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.19, 2907.21,
2907.22, 2907.23, 2907.24, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2909.02,
2909.03, 2909.04, 2909.05, 2911.01, 2911.02, 2911.11, 2911.12, 2913.02, 2913.03, 2913.04,
2913.041, 2913.05, 2913.06, 2913.11, 2913.21, 2913.31, 2913.32, 2913.33, 2913.34, 2913.40,
2913.41, 2913.42, 2913.43, 2913.44, 2913.441, 2913.45, 2913.46, 2913.47, 2913.48, 2913.49,
2917.01, 2917.02, 2917.03, 2917.31, 2919.12, 2919.22, 2919.224, 2919.225, 2919.24, 2919.25,
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2921.03, 2921.11, 2921.13, 2921.14, 2921.34, 2921.35, 2923.01, 2923.12, 2923.13, 2923.161,
2925.02, 2925.03, 2925.04, 2925.05, 2925.06, or 3716.11 of the Revised Code, felonious sexual
penetration in violation of former section 2907.12 of the Revised Code, a violation of section
2905.04 of the Revised Code as it existed prior to July 1, 1996, a violation of section 2919.23 of the
Revised Code that would have been a violation of section 2905.04 of the Revised Code as it existed
prior to July 1, 1996, had the violation been committed prior to that date, a violation of section
2925.11 of the Revised Code that is not a minor drug possession offense, a violation of section
2923.02 or 2923.03 of the Revised Code that relates to a crime specified in this division, or a second
violation of section 4511.19 of the Revised Code within five years of the date of application for
licensure or certification.
that is substantially equivalent to any of the offenses or violations described in division (A)(5)(a) of
this section.
(6) Upon receipt of a request pursuant to section 5153.111 of the Revised Code, a completed
obtained in the manner described in division (C)(2) of this section, the superintendent of the bureau
of criminal identification and investigation shall conduct a criminal records check in the manner
that the person who is the subject of the request previously has been convicted of or pleaded guilty to
any of the following:
2903.16, 2903.21, 2903.34, 2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04, 2907.05,
2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23, 2907.25, 2907.31, 2907.32,
2907.321, 2907.322, 2907.323, 2909.02, 2909.03, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12,
2919.22, 2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.04, 2925.05,
2925.06, or 3716.11 of the Revised Code, felonious sexual penetration in violation of former section
2907.12 of the Revised Code, a violation of section 2905.04 of the Revised Code as it existed prior to
July 1, 1996, a violation of section 2919.23 of the Revised Code that would have been a violation of
section 2905.04 of the Revised Code as it existed prior to July 1, 1996, had the violation been
committed prior to that date, or a violation of section 2925.11 of the Revised Code that is not a minor
drug possession offense;
that is substantially equivalent to any of the offenses listed in division (A)(6)(a) of this section.
(7) On receipt of a request for a criminal records check from an individual pursuant to section
4749.03 or 4749.06 of the Revised Code, accompanied by a completed copy of the form prescribed
in division (C)(1) of this section and a set of fingerprint impressions obtained in a manner described
in division (C)(2) of this section, the superintendent of the bureau of criminal identification and
investigation shall conduct a criminal records check in the manner described in division (B) of this
section to determine whether any information exists indicating that the person who is the subject of
the request has been convicted of or pleaded guilty to a felony in this state or in any other state. If the
individual indicates that a firearm will be carried in the course of business, the superintendent shall
require information from the federal bureau of investigation as described in division (B)(2) of this
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section. Subject to division (F) of this section, the superintendent shall report the findings of the
criminal records check and any information the federal bureau of investigation provides to the
director of public safety.
(8) On receipt of a request pursuant to section 1321.37, 1321.53, or 4763.05 of the Revised
Code, a completed form prescribed pursuant to division (C)(1) of this section, and a set of fingerprint
respect to any person who has applied for a license, permit, or certification from the department of
commerce or a division in the department. The superintendent shall conduct the criminal records
check in the manner described in division (B) of this section to determine whether any information
exists that indicates that the person who is the subject of the request previously has been convicted of
or pleaded guilty to any of the following: a violation of section 2913.02, 2913.11, 2913.31, 2913.51,
or 2925.03 of the Revised Code; any other criminal offense involving theft, receiving stolen property,
embezzlement, forgery, fraud, passing bad checks, money laundering, or drug trafficking, or any
criminal offense involving money or securities, as set forth in Chapters 2909., 2911., 2913., 2915.,
2921., 2923., and 2925. of the Revised Code; or any existing or former law of this state, any other
state, or the United States that is substantially equivalent to those offenses.
(9) On receipt of a request for a criminal records check from the treasurer of state under
section 113.041 of the Revised Code or from an individual under section 928.03, 4701.08, 4715.101,
4717.061, 4725.121, 4725.501, 4729.071, 4729.53, 4729.90, 4729.92, 4730.101, 4730.14, 4730.28,
4731.081, 4731.15, 4731.171, 4731.222, 4731.281, 4731.531, 4732.091, 4734.202, 4740.061,
4741.10, 4747.051, 4751.20, 4751.201, 4751.202, 4751.21, 4753.061, 4755.70, 4757.101, 4759.061,
4760.032, 4760.06, 4761.051, 4762.031, 4762.06, 4774.031, 4774.06, 4776.021, 4778.04, 4778.07,
4779.091, or 4783.04 of the Revised Code, accompanied by a completed form prescribed under
division (C)(1) of this section and a set of fingerprint impressions obtained in the manner described
in division (C)(2) of this section, the superintendent of the bureau of criminal identification and
investigation shall conduct a criminal records check in the manner described in division (B) of this
section to determine whether any information exists that indicates that the person who is the subject
of the request has been convicted of or pleaded guilty to any criminal offense in this state or any
other state. Subject to division (F) of this section, the superintendent shall send the results of a check
requested under section 113.041 of the Revised Code to the treasurer of state and shall send the
results of a check requested under any of the other listed sections to the licensing board specified by
the individual in the request.
(10) On receipt of a request pursuant to section 124.74, 718.131, 1121.23, 1315.141, 1733.47,
or 1761.26 of the Revised Code, a completed form prescribed pursuant to division (C)(1) of this
section, and a set of fingerprint impressions obtained in the manner described in division (C)(2) of
this section, the superintendent of the bureau of criminal identification and investigation shall
whether any information exists that indicates that the person who is the subject of the request
previously has been convicted of or pleaded guilty to any criminal offense under any existing or
former law of this state, any other state, or the United States.
(11) On receipt of a request for a criminal records check from an appointing or licensing
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authority under section 3772.07 of the Revised Code, a completed form prescribed under division (C)
(1) of this section, and a set of fingerprint impressions obtained in the manner prescribed in division
(C)(2) of this section, the superintendent of the bureau of criminal identification and investigation
shall conduct a criminal records check in the manner described in division (B) of this section to
determine whether any information exists that indicates that the person who is the subject of the
request previously has been convicted of or pleaded guilty or no contest to any offense under any
existing or former law of this state, any other state, or the United States that is a disqualifying offense
as defined in section 3772.07 of the Revised Code or substantially equivalent to such an offense.
respect to any person for whom a criminal records check is required under that section. The
superintendent shall conduct the criminal records check in the manner described in division (B) of
this section to determine whether any information exists that indicates that the person who is the
subject of the request previously has been convicted of or pleaded guilty to any of the following:
2903.16, 2903.21, 2903.34, 2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322,
2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11,
2913.21, 2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 2923.12, 2923.13,
2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 2925.22, 2925.23, or 3716.11 of the Revised Code;
(b) An existing or former law of this state, any other state, or the United States that is
substantially equivalent to any of the offenses listed in division (A)(12)(a) of this section.
(13) On receipt of a request pursuant to section 3796.12 of the Revised Code, a completed
obtained in a manner described in division (C)(2) of this section, the superintendent of the bureau of
criminal identification and investigation shall conduct a criminal records check in the manner
the following:
(a) A disqualifying offense as specified in rules adopted under division (B)(2)(b) of section
3796.03 of the Revised Code if the person who is the subject of the request is an administrator or
other person responsible for the daily operation of, or an owner or prospective owner, officer or
prospective officer, or board member or prospective board member of, an entity seeking a license
from the department of commerce under Chapter 3796. of the Revised Code;
(b) A disqualifying offense as specified in rules adopted under division (B)(2)(b) of section
3796.04 of the Revised Code if the person who is the subject of the request is an administrator or
other person responsible for the daily operation of, or an owner or prospective owner, officer or
prospective officer, or board member or prospective board member of, an entity seeking a license
from the state board of pharmacy under Chapter 3796. of the Revised Code.
(14) On receipt of a request required by section 3796.13 of the Revised Code, a completed
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obtained in a manner described in division (C)(2) of this section, the superintendent of the bureau of
criminal identification and investigation shall conduct a criminal records check in the manner
the following:
(a) A disqualifying offense as specified in rules adopted under division (B)(8)(a) of section
3796.03 of the Revised Code if the person who is the subject of the request is seeking employment
with an entity licensed by the department of commerce under Chapter 3796. of the Revised Code;
(b) A disqualifying offense as specified in rules adopted under division (B)(14)(a) of section
3796.04 of the Revised Code if the person who is the subject of the request is seeking employment
with an entity licensed by the state board of pharmacy under Chapter 3796. of the Revised Code.
(15) On receipt of a request pursuant to section 4768.06 of the Revised Code, a completed
form prescribed under division (C)(1) of this section, and a set of fingerprint impressions obtained in
the manner described in division (C)(2) of this section, the superintendent of the bureau of criminal
identification and investigation shall conduct a criminal records check in the manner described in
division (B) of this section to determine whether any information exists indicating that the person
who is the subject of the request has been convicted of or pleaded guilty to a felony in this state or in
any other state.
(16) On receipt of a request pursuant to division (B) of section 4764.07 or division (A) of
section 4735.143 of the Revised Code, a completed form prescribed under division (C)(1) of this
section, and a set of fingerprint impressions obtained in the manner described in division (C)(2) of
this section, the superintendent of the bureau of criminal identification and investigation shall
whether any information exists indicating that the person who is the subject of the request has been
convicted of or pleaded guilty to any crime of moral turpitude, a felony, or an equivalent offense in
any other state or the United States.
(17) On receipt of a request for a criminal records check under section 147.022 of the
Revised Code, a completed form prescribed under division (C)(1) of this section, and a set of
fingerprint impressions obtained in the manner prescribed in division (C)(2) of this section, the
superintendent of the bureau of criminal identification and investigation shall conduct a criminal
records check in the manner described in division (B) of this section to determine whether any
information exists that indicates that the person who is the subject of the request previously has been
convicted of or pleaded guilty or no contest to any disqualifying offense, as defined in section
147.011 of the Revised Code, or to any offense under any existing or former law of this state, any
other state, or the United States that is substantially equivalent to such a disqualifying offense.
(B) Subject to division (F) of this section, the superintendent shall conduct any criminal
records check to be conducted under this section as follows:
(1) The superintendent shall review or cause to be reviewed any relevant information
gathered and compiled by the bureau under division (A) of section 109.57 of the Revised Code that
relates to the person who is the subject of the criminal records check, including, if the criminal
records check was requested under section 113.041, 121.08, 124.74, 173.27, 173.38, 173.381,
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718.131, 928.03, 1121.23, 1315.141, 1321.37, 1321.53, 1733.47, 1761.26, 2151.86, 3301.32,
3301.541, 3319.39, 3701.881, 3712.09, 3721.121, 3772.07, 3796.12, 3796.13, 4729.071, 4729.53,
4729.90, 4729.92, 4749.03, 4749.06, 4763.05, 4764.07, 4768.06, 5104.013, 5164.34, 5164.341,
5164.342, 5123.081, 5123.169, or 5153.111 of the Revised Code, any relevant information contained
in records that have been sealed under section 2953.32 of the Revised Code;
(2) If the request received by the superintendent asks for information from the federal bureau
of investigation, the superintendent shall request from the federal bureau of investigation any
information it has with respect to the person who is the subject of the criminal records check,
including fingerprint-based checks of national crime information databases as described in 42 U.S.C.
671 if the request is made pursuant to section 2151.86 or 5104.013 of the Revised Code or if any
other Revised Code section requires fingerprint-based checks of that nature, and shall review or
cause to be reviewed any information the superintendent receives from that bureau. If a request under
section 3319.39 of the Revised Code asks only for information from the federal bureau of
investigation, the superintendent shall not conduct the review prescribed by division (B)(1) of this
section.
(3) The superintendent or the superintendent's designee may request criminal history records
from other states or the federal government pursuant to the national crime prevention and privacy
compact set forth in section 109.571 of the Revised Code.
(4) The superintendent shall include in the results of the criminal records check a list or
description of the offenses listed or described in division (A)(1), (2), (3), (4), (5), (6), (7), (8), (9),
(10), (11), (12), (13), (14), (15), (16), or (17) of this section, whichever division requires the
superintendent to conduct the criminal records check. The superintendent shall exclude from the
results any information the dissemination of which is prohibited by federal law.
(5) The superintendent shall send the results of the criminal records check to the person to
whom it is to be sent not later than the following number of days after the date the superintendent
receives the request for the criminal records check, the completed form prescribed under division (C)
(1) of this section, and the set of fingerprint impressions obtained in the manner described in division
(C)(2) of this section:
(a) If the superintendent is required by division (A) of this section (other than division (A)(3)
of this section) to conduct the criminal records check, thirty;
(b) If the superintendent is required by division (A)(3) of this section to conduct the criminal
records check, sixty.
(C)(1) The superintendent shall prescribe a form to obtain the information necessary to
conduct a criminal records check from any person for whom a criminal records check is to be
conducted under this section. The form that the superintendent prescribes pursuant to this division
may be in a tangible format, in an electronic format, or in both tangible and electronic formats.
(2) The superintendent shall prescribe standard impression sheets to obtain the fingerprint
impressions of any person for whom a criminal records check is to be conducted under this section.
Any person for whom a records check is to be conducted under this section shall obtain the
fingerprint impressions at a county sheriff's office, municipal police department, or any other entity
with the ability to make fingerprint impressions on the standard impression sheets prescribed by the
superintendent. The office, department, or entity may charge the person a reasonable fee for making
S. B. No. 260 133rd G.A.
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the impressions. The standard impression sheets the superintendent prescribes pursuant to this
division may be in a tangible format, in an electronic format, or in both tangible and electronic
formats.
(3) Subject to division (D) of this section, the superintendent shall prescribe and charge a
reasonable fee for providing a criminal records check under this section. The person requesting the
criminal records check shall pay the fee prescribed pursuant to this division. In the case of a request
under section 1121.23, 1155.03, 1163.05, 1315.141, 1733.47, 1761.26, 2151.33, 2151.412, or
5164.34 of the Revised Code, the fee shall be paid in the manner specified in that section.
(4) The superintendent of the bureau of criminal identification and investigation may
prescribe methods of forwarding fingerprint impressions and information necessary to conduct a
criminal records check, which methods shall include, but not be limited to, an electronic method.
(D) The results of a criminal records check conducted under this section, other than a
criminal records check specified in division (A)(7) of this section, are valid for the person who is the
subject of the criminal records check for a period of one year from the date upon which the
superintendent completes the criminal records check. If during that period the superintendent
receives another request for a criminal records check to be conducted under this section for that
person, the superintendent shall provide the results from the previous criminal records check of the
person at a lower fee than the fee prescribed for the initial criminal records check.
(E) When the superintendent receives a request for information from a registered private
provider, the superintendent shall proceed as if the request was received from a school district board
of education under section 3319.39 of the Revised Code. The superintendent shall apply division (A)
(1)(c) of this section to any such request for an applicant who is a teacher.
(F)(1) Subject to division (F)(2) of this section, all information regarding the results of a
criminal records check conducted under this section that the superintendent reports or sends under
division (A)(7) or (9) of this section to the director of public safety, the treasurer of state, or the
person, board, or entity that made the request for the criminal records check shall relate to the
conviction of the subject person, or the subject person's plea of guilty to, a criminal offense.
(2) Division (F)(1) of this section does not limit, restrict, or preclude the superintendent's
release of information that relates to the arrest of a person who is eighteen years of age or older, to an
adjudication of a child as a delinquent child, or to a criminal conviction of a person under eighteen
years of age in circumstances in which a release of that nature is authorized under division (E)(2),
(3), or (4) of section 109.57 of the Revised Code pursuant to a rule adopted under division (E)(1) of
that section.
(G) As used in this section:
(1) "Criminal records check" means any criminal records check conducted by the
superintendent of the bureau of criminal identification and investigation in accordance with division
(B) of this section.
(2) "Minor drug possession offense" has the same meaning as in section 2925.01 of the
Revised Code.
(3) "OVI or OVUAC violation" means a violation of section 4511.19 of the Revised Code or
a violation of an existing or former law of this state, any other state, or the United States that is
substantially equivalent to section 4511.19 of the Revised Code.
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(4) "Registered private provider" means a nonpublic school or entity registered with the
superintendent of public instruction under section 3310.41 of the Revised Code to participate in the
autism scholarship program or section 3310.58 of the Revised Code to participate in the Jon Peterson
special needs scholarship program.
Sec. 2919.123. (A) No person shall knowingly give, sell, dispense, administer, or otherwise
provide, or prescribe RU-486 (mifepristone) to another for the purpose of inducing an abortion in any
person or enabling the other person to induce an abortion in any person, unless the person who gives,
sells, dispenses, administers, or otherwise provides or prescribes the RU-486 (mifepristone) is a
physician, the physician satisfies all the criteria established by federal law that a physician must
satisfy in order to provide RU-486 (mifepristone) for inducing abortions, and the physician provides
the RU-486 (mifepristone) to the other person for the purpose of inducing an abortion in accordance
with all provisions of federal law that govern the use of RU-486 (mifepristone) for inducing
abortions. A person who gives, sells, dispenses, administers, or otherwise provides, or prescribes RU-
486 (mifepristone) to another as described in division (A) of this section shall not be prosecuted
based on a violation of the criteria contained in this division unless the person knows that the person
is not a physician, that the person did not satisfy all the specified criteria established by federal law,
or that the person did not provide the RU-486 (mifepristone) in accordance with the specified
provisions of federal law, whichever is applicable.
(B) No physician who provides RU-486 (mifepristone) to another for the purpose of inducing
an abortion as authorized under division (A) of this section shall knowingly fail to comply with the
applicable requirements of any federal law that pertain to follow-up examinations or care for persons
to whom or for whom RU-486 (mifepristone) is provided for the purpose of inducing an abortion.
(C)(1) If a physician provides RU-486 (mifepristone) to another for the purpose of inducing
an abortion as authorized under division (A) of this section and if the physician knows that the person
who uses the RU-486 (mifepristone) for the purpose of inducing an abortion experiences during or
after the use an incomplete abortion, severe bleeding, or an adverse reaction to the RU-486
(mifepristone) or is hospitalized, receives a transfusion, or experiences any other serious event, the
physician promptly must provide a written report of the incomplete abortion, severe bleeding,
adverse reaction, hospitalization, transfusion, or serious event to the state medical board. The board
shall compile and retain all reports it receives under this division. Except as otherwise provided in
this division, all reports the board receives under this division are public records open to inspection
under section 149.43 of the Revised Code. In no case shall the board release to any person the name
or any other personal identifying information regarding a person who uses RU-486 (mifepristone) for
the purpose of inducing an abortion and who is the subject of a report the board receives under this
division.
(2) No physician who provides RU-486 (mifepristone) to another for the purpose of inducing
an abortion as authorized under division (A) of this section shall knowingly fail to file a report
required under division (C)(1) of this section.
(D) Division (A) of this section does not apply to any of the following:
(1) A pregnant woman who obtains or possesses RU-486 (mifepristone) for the purpose of
inducing an abortion to terminate her own pregnancy;
(2) The legal transport of RU-486 (mifepristone) by any person or entity and the legal
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delivery of the RU-486 (mifepristone) by any person to the recipient, provided that this division does
not apply regarding any conduct related to the RU-486 (mifepristone) other than its transport and
delivery to the recipient;
(3) The distribution, provision, or sale of RU-486 (mifepristone) by any legal manufacturer or
distributor of RU-486 (mifepristone), provided the manufacturer or distributor made a good faith
effort to comply with any applicable requirements of federal law regarding the distribution,
provision, or sale.
(E) Whoever violates this section is guilty of unlawful distribution of an abortion-inducing
drug, a felony of the fourth degree. If the offender previously has been convicted of or pleaded guilty
to a violation of this section or of section 2919.12, 2919.121, 2919.13, 2919.14, 2919.15, 2919.151,
2919.17, or 2919.18 of the Revised Code, unlawful distribution of an abortion-inducing drug is a
felony of the third degree.
If the offender is a professionally licensed person, in addition to any other sanction imposed
by law for the offense, the offender is subject to sanctioning as provided by law by the regulatory or
licensing board or agency that has the administrative authority to suspend or revoke the offender's
professional license, including the sanctioning provided in section 4731.22 of the Revised Code for
offenders who have a certificate to practice or certificate of registration issued under that chapter.
(F) As used in this section:
(1) "Federal law" means any law, rule, or regulation of the United States or any drug approval
letter of the food and drug administration of the United States that governs or regulates the use of
RU-486 (mifepristone) for the purpose of inducing abortions.
(2) "Personal identifying information" has the same meaning as in section 2913.49 of the
Revised Code.
(3) "Physician" has the same meaning as in section 2305.113 of the Revised Code.
(4) "Professionally licensed person" has the same meaning as in section 2925.01 of the
Revised Code.
Sec. 2919.124. (A) As used in this section:
(1) "Abortion-inducing drug" means a drug or regimen of drugs that causes the termination of
a clinically diagnosable pregnancy, including any drug identified in section 2919.123 of the Revised
Code.
(2) "Physician" has the same meaning as in section 2305.113 of the Revised Code.
(3) "Professionally licensed person" has the same meaning as in section 2925.01 of the
Revised Code.
(B) No physician shall personally furnish or otherwise provide an abortion-inducing drug to a
pregnant woman unless the physician is physically present at the location where the initial dose of
the drug or regimen of drugs is consumed at the time the initial dose is consumed.
(C) No physician who personally furnishes or otherwise provides an abortion-inducing drug
to another for the purpose of inducing an abortion shall knowingly fail to comply with division (B) of
this section.
(D) Nothing in this section shall be construed as creating or recognizing a right to abortion or
affirming the lawfulness of an abortion that would otherwise be unlawful.
(E) Whoever violates this section is guilty of unlawful performance of a drug-induced
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12
abortion, a felony of the fourth degree. If the offender previously has been convicted of or pleaded
guilty to a violation of this section or of section 2919.12, 2919.121, 2919.123, 2919.13, 2919.14,
2919.15, 2919.151, 2919.17, or 2919.18 of the Revised Code, unlawful performance of a drug-
induced abortion is a felony of the third degree.
If the offender is a professionally licensed person, in addition to any other sanction imposed
by law for the offense, the offender is subject to sanctioning as provided by law by the regulatory or
licensing board or agency that has the administrative authority to suspend or revoke the offender's
professional license, including the sanctioning provided in section 4731.22 of the Revised Code for
offenders who have a certificate to practice or certificate of registration issued under that chapter.
Sec. 2953.25. (A) As used in this section:
(1) "Collateral sanction" means a penalty, disability, or disadvantage that is related to
employment or occupational licensing, however denominated, as a result of the individual's
conviction of or plea of guilty to an offense and that applies by operation of law in this state whether
or not the penalty, disability, or disadvantage is included in the sentence or judgment imposed.
"Collateral sanction" does not include imprisonment, probation, parole, supervised release,
forfeiture, restitution, fine, assessment, or costs of prosecution.
(2) "Decision-maker" includes, but is not limited to, the state acting through a department,
agency, board, commission, or instrumentality established by the law of this state for the exercise of
any function of government, a political subdivision, an educational institution, or a government
contractor or subcontractor made subject to this section by contract, law, or ordinance.
(3) "Department-funded program" means a residential or nonresidential program that is not a
term in a state correctional institution, that is funded in whole or part by the department of
rehabilitation and correction, and that is imposed as a sanction for an offense, as part of a sanction
that is imposed for an offense, or as a term or condition of any sanction that is imposed for an
offense.
(4) "Designee" means the person designated by the deputy director of the division of parole
and community services to perform the duties designated in division (B) of this section.
(5) "Division of parole and community services" means the division of parole and community
services of the department of rehabilitation and correction.
(6) "Offense" means any felony or misdemeanor under the laws of this state.
(7) "Political subdivision" has the same meaning as in section 2969.21 of the Revised Code.
(8) "Discretionary civil impact," "licensing agency," and "mandatory civil impact" have the
same meanings as in section 2961.21 of the Revised Code.
(B)(1) An individual who is subject to one or more collateral sanctions as a result of being
convicted of or pleading guilty to an offense and who either has served a term in a state correctional
institution for any offense or has spent time in a department-funded program for any offense may file
a petition with the designee of the deputy director of the division of parole and community services
for a certificate of qualification for employment.
(2) An individual who is subject to one or more collateral sanctions as a result of being
convicted of or pleading guilty to an offense and who is not in a category described in division (B)(1)
of this section may file for a certificate of qualification for employment by doing either of the
following:
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(a) In the case of an individual who resides in this state, filing a petition with the court of
common pleas of the county in which the person resides or with the designee of the deputy director
of the division of parole and community services;
(b) In the case of an individual who resides outside of this state, filing a petition with the
court of common pleas of any county in which any conviction or plea of guilty from which the
individual seeks relief was entered or with the designee of the deputy director of the division of
parole and community services.
(3) A petition under division (B)(1) or (2) of this section shall be made on a copy of the form
prescribed by the division of parole and community services under division (J) of this section, shall
contain all of the information described in division (F) of this section, and, except as provided in
division (B)(6) of this section, shall be accompanied by an application fee of fifty dollars.
(4)(a) Except as provided in division (B)(4)(b) of this section, an individual may file a
petition under division (B)(1) or (2) of this section at any time after the expiration of whichever of
the following is applicable:
(i) If the offense that resulted in the collateral sanction from which the individual seeks relief
is a felony, at any time after the expiration of one year from the date of release of the individual from
any period of incarceration in a state or local correctional facility that was imposed for that offense
and all periods of supervision imposed after release from the period of incarceration or, if the
individual was not incarcerated for that offense, at any time after the expiration of one year from the
date of the individual's final release from all other sanctions imposed for that offense.
(ii) If the offense that resulted in the collateral sanction from which the individual seeks relief
is a misdemeanor, at any time after the expiration of six months from the date of release of the
individual from any period of incarceration in a local correctional facility that was imposed for that
offense and all periods of supervision imposed after release from the period of incarceration or, if the
individual was not incarcerated for that offense, at any time after the expiration of six months from
the date of the final release of the individual from all sanctions imposed for that offense including
any period of supervision.
(b) The department of rehabilitation and correction may establish criteria by rule adopted
under Chapter 119. of the Revised Code that, if satisfied by an individual, would allow the individual
to file a petition before the expiration of six months or one year from the date of final release,
whichever is applicable under division (B)(4)(a) of this section.
(5)(a) A designee that receives a petition for a certificate of qualification for employment
from an individual under division (B)(1) or (2) of this section shall review the petition to determine
whether it is complete. If the petition is complete, the designee shall forward the petition, the
application fee, and any other information the designee possesses that relates to the petition, to the
court of common pleas of the county in which the individual resides if the individual submitting the
petition resides in this state or, if the individual resides outside of this state, to the court of common
pleas of the county in which the conviction or plea of guilty from which the individual seeks relief
was entered.
(b) A court of common pleas that receives a petition for a certificate of qualification for
employment from an individual under division (B)(2) of this section, or that is forwarded a petition
for such a certificate under division (B)(5)(a) of this section, shall attempt to determine all other
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courts in this state in which the individual was convicted of or pleaded guilty to an offense other than
the offense from which the individual is seeking relief. The court that receives or is forwarded the
petition shall notify all other courts in this state that it determines under this division were courts in
which the individual was convicted of or pleaded guilty to an offense other than the offense from
which the individual is seeking relief that the individual has filed the petition and that the court may
send comments regarding the possible issuance of the certificate.
A court of common pleas that receives a petition for a certificate of qualification for
employment under division (B)(2) of this section shall notify the county's prosecuting attorney that
the individual has filed the petition.
A court of common pleas that receives a petition for a certificate of qualification for
employment under division (B)(2) of this section, or that is forwarded a petition for qualification
under division (B)(5)(a) of this section may direct the clerk of court to process and record all notices
required in or under this section. Except as provided in division (B)(6) of this section, the court shall
pay thirty dollars of the application fee into the state treasury and twenty dollars of the application
fee into the county general revenue fund.
(6) Upon receiving a petition for a certificate of qualification for employment filed by an
individual under division (B)(1) or (2) of this section, a court of common pleas or the designee of the
deputy director of the division of parole and community services who receives the petition may
waive all or part of the fifty-dollar filing fee for an applicant who is indigent. If an application fee is
partially waived, the first twenty dollars of the fee that is collected shall be paid into the county
general revenue fund. Any partial fee collected in excess of twenty dollars shall be paid into the state
treasury.
(C)(1) Upon receiving a petition for a certificate of qualification for employment filed by an
individual under division (B)(2) of this section or being forwarded a petition for such a certificate
under division (B)(5)(a) of this section, the court shall review the individual's petition, the
individual's criminal history, all filings submitted by the prosecutor or by the victim in accordance
with rules adopted by the division of parole and community services, the applicant's military service
record, if applicable, and whether the applicant has an emotional, mental, or physical condition that is
traceable to the applicant's military service in the armed forces of the United States and that was a
contributing factor in the commission of the offense or offenses, and all other relevant evidence. The
court may order any report, investigation, or disclosure by the individual that the court believes is
necessary for the court to reach a decision on whether to approve the individual's petition for a
certificate of qualification for employment.
(2) Upon receiving a petition for a certificate of qualification for employment filed by an
individual under division (B)(2) of this section or being forwarded a petition for such a certificate
under division (B)(5)(a) of this section, except as otherwise provided in this division, the court shall
decide whether to issue the certificate within sixty days after the court receives or is forwarded the
completed petition and all information requested for the court to make that decision. Upon request of
the individual who filed the petition, the court may extend the sixty-day period specified in this
division.
(3) Except as provided in division (C)(5) of this section and subject to division (C)(7) of this
section, a court that receives an individual's petition for a certificate of qualification for employment
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under division (B)(2) of this section or that is forwarded a petition for such a certificate under
division (B)(5)(a) of this section may issue a certificate of qualification for employment, at the
court's discretion, if the court finds that the individual has established all of the following by a
preponderance of the evidence:
(a) Granting the petition will materially assist the individual in obtaining employment or
occupational licensing.
(b) The individual has a substantial need for the relief requested in order to live a law-abiding
life.
(c) Granting the petition would not pose an unreasonable risk to the safety of the public or
any individual.
(4) The submission of an incomplete petition by an individual shall not be grounds for the
designee or court to deny the petition.
(5) Subject to division (C)(6) of this section, an individual is rebuttably presumed to be
eligible for a certificate of qualification for employment if the court that receives the individual's
petition under division (B)(2) of this section or that is forwarded a petition under division (B)(5)(a)
of this section finds all of the following:
(a) The application was filed after the expiration of the applicable waiting period prescribed
in division (B)(4) of this section;
(b) If the offense that resulted in the collateral sanction from which the individual seeks relief
is a felony, at least three years have elapsed since the date of release of the individual from any
period of incarceration in a state or local correctional facility that was imposed for that offense and
all periods of supervision imposed after release from the period of incarceration or, if the individual
was not incarcerated for that offense, at least three years have elapsed since the date of the
individual's final release from all other sanctions imposed for that offense;
(c) If the offense that resulted in the collateral sanction from which the individual seeks relief
is a misdemeanor, at least one year has elapsed since the date of release of the individual from any
period of incarceration in a local correctional facility that was imposed for that offense and all
periods of supervision imposed after release from the period of incarceration or, if the individual was
not incarcerated for that offense, at least one year has elapsed since the date of the final release of the
individual from all sanctions imposed for that offense including any period of supervision.
(6) An application that meets all of the requirements for the presumption under division (C)
(5) of this section shall be denied only if the court that receives the petition finds that the evidence
reviewed under division (C)(1) of this section rebuts the presumption of eligibility for issuance by
establishing, by clear and convincing evidence, that the applicant has not been rehabilitated.
(7) A certificate of qualification for employment shall not create relief from any of the
following collateral sanctions:
(a) Requirements imposed by Chapter 2950. of the Revised Code and rules adopted under
sections 2950.13 and 2950.132 of the Revised Code;
(b) A driver's license, commercial driver's license, or probationary license suspension,
cancellation, or revocation pursuant to section 4510.037, 4510.07, 4511.19, or 4511.191 of the
Revised Code if the relief sought is available pursuant to section 4510.021 or division (B) of section
4510.13 of the Revised Code;
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(c) Restrictions on employment as a prosecutor or law enforcement officer;
(d) The denial, ineligibility, or automatic suspension of a license that is imposed upon an
individual applying for or holding a license as a health care professional under Title XLVII of the
Revised Code if the individual is convicted of, pleads guilty to, is subject to a judicial finding of
eligibility for intervention in lieu of conviction in this state under section 2951.041 of the Revised
Code, or is subject to treatment or intervention in lieu of conviction for a violation of section
2903.01, 2903.02, 2903.03, 2903.11, 2905.01, 2907.02, 2907.03, 2907.05, 2909.02, 2911.01,
2911.11, or 2919.123, or 2919.124 of the Revised Code;
(e) The immediate suspension of a license, certificate, or evidence of registration that is
imposed upon an individual holding a license as a health care professional under Title XLVII of the
Revised Code pursuant to division (C) of section 3719.121 of the Revised Code;
(f) The denial or ineligibility for employment in a pain clinic under division (B)(4) of section
(g) The mandatory suspension of a license that is imposed on an individual applying for or
holding a license as a health care professional under Title XLVII of the Revised Code pursuant to
section 3123.43 of the Revised Code.
(8) If a court that receives an individual's petition for a certificate of qualification for
employment under division (B)(2) of this section or that is forwarded a petition for such a certificate
under division (B)(5)(a) of this section denies the petition, the court shall provide written notice to
the individual of the court's denial. The court may place conditions on the individual regarding the
individual's filing of any subsequent petition for a certificate of qualification for employment. The
written notice must notify the individual of any conditions placed on the individual's filing of a
subsequent petition for a certificate of qualification for employment.
If a court of common pleas that receives an individual's petition for a certificate of
qualification for employment under division (B)(2) of this section or that is forwarded a petition for
such a certificate under division (B)(5)(a) of this section denies the petition, the individual may
appeal the decision to the court of appeals only if the individual alleges that the denial was an abuse
of discretion on the part of the court of common pleas.
(D)(1) A certificate of qualification for employment issued to an individual lifts the automatic
bar of a collateral sanction, and a decision-maker shall consider on a case-by-case basis whether to
grant or deny the issuance or restoration of an occupational license or an employment opportunity,
notwithstanding the individual's possession of the certificate, without, however, reconsidering or
rejecting any finding made by a designee or court under division (C)(3) of this section.
(2) The certificate constitutes a rebuttable presumption that the person's criminal convictions
are insufficient evidence that the person is unfit for the license, employment opportunity, or
certification in question. Notwithstanding the presumption established under this division, the agency
may deny the license or certification for the person if it determines that the person is unfit for
issuance of the license.
(3) If an employer that has hired a person who has been issued a certificate of qualification
for employment applies to a licensing agency for a license or certification and the person has a
conviction or guilty plea that otherwise would bar the person's employment with the employer or
licensure for the employer because of a mandatory civil impact, the agency shall give the person
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individualized consideration, notwithstanding the mandatory civil impact, the mandatory civil impact
shall be considered for all purposes to be a discretionary civil impact, and the certificate constitutes a
rebuttable presumption that the person's criminal convictions are insufficient evidence that the person
is unfit for the employment, or that the employer is unfit for the license or certification, in question.
(E) A certificate of qualification for employment does not grant the individual to whom the
certificate was issued relief from the mandatory civil impacts identified in division (A)(1) of section
2961.01 or division (B) of section 2961.02 of the Revised Code.
(F) A petition for a certificate of qualification for employment filed by an individual under
division (B)(1) or (2) of this section shall include all of the following:
(1) The individual's name, date of birth, and social security number;
(2) All aliases of the individual and all social security numbers associated with those aliases;
(3) The individual's residence address, including the city, county, and state of residence and
zip code;
(4) The length of time that the individual has resided in the individual's current state of
residence, expressed in years and months of residence;
(5) A general statement as to why the individual has filed the petition and how the certificate
of qualification for employment would assist the individual;
(6) A summary of the individual's criminal history with respect to each offense that is a
disqualification from employment or licensing in an occupation or profession, including the years of
each conviction or plea of guilty for each of those offenses;
(7) A summary of the individual's employment history, specifying the name of, and dates of
employment with, each employer;
(8) Verifiable references and endorsements;
(9) The name of one or more immediate family members of the individual, or other persons
with whom the individual has a close relationship, who support the individual's reentry plan;
(10) A summary of the reason the individual believes the certificate of qualification for
employment should be granted;
(11) Any other information required by rule by the department of rehabilitation and
correction.
(G)(1) In a judicial or administrative proceeding alleging negligence or other fault, a
certificate of qualification for employment issued to an individual under this section may be
introduced as evidence of a person's due care in hiring, retaining, licensing, leasing to, admitting to a
school or program, or otherwise transacting business or engaging in activity with the individual to
whom the certificate of qualification for employment was issued if the person knew of the certificate
at the time of the alleged negligence or other fault.
(2) In any proceeding on a claim against an employer for negligent hiring, a certificate of
qualification for employment issued to an individual under this section shall provide immunity for
the employer as to the claim if the employer knew of the certificate at the time of the alleged
negligence.
(3) If an employer hires an individual who has been issued a certificate of qualification for
employment under this section, if the individual, after being hired, subsequently demonstrates
dangerousness or is convicted of or pleads guilty to a felony, and if the employer retains the
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individual as an employee after the demonstration of dangerousness or the conviction or guilty plea,
the employer may be held liable in a civil action that is based on or relates to the retention of the
individual as an employee only if it is proved by a preponderance of the evidence that the person
having hiring and firing responsibility for the employer had actual knowledge that the employee was
dangerous or had been convicted of or pleaded guilty to the felony and was willful in retaining the
individual as an employee after the demonstration of dangerousness or the conviction or guilty plea
of which the person has actual knowledge.
(H) A certificate of qualification for employment issued under this section shall be revoked if
the individual to whom the certificate of qualification for employment was issued is convicted of or
pleads guilty to a felony offense committed subsequent to the issuance of the certificate of
qualification for employment. The department of rehabilitation and correction shall periodically
review the certificates listed in the database described in division (K) of this section to identify those
that are subject to revocation under this division. Upon identifying a certificate of qualification for
employment that is subject to revocation, the department shall note in the database that the certificate
has been revoked, the reason for revocation, and the effective date of revocation, which shall be the
date of the conviction or plea of guilty subsequent to the issuance of the certificate.
(I) A designee's forwarding, or failure to forward, a petition for a certificate of qualification
for employment to a court or a court's issuance, or failure to issue, a petition for a certificate of
qualification for employment to an individual under division (B) of this section does not give rise to a
claim for damages against the department of rehabilitation and correction or court.
(J) The division of parole and community services shall adopt rules in accordance with
Chapter 119. of the Revised Code for the implementation and administration of this section and shall
prescribe the form for the petition to be used under division (B)(1) or (2) of this section. The form for
the petition shall include places for all of the information specified in division (F) of this section.
(K) The department of rehabilitation and correction shall maintain a database that identifies
granted certificates and revoked certificates and tracks the number of certificates granted and
revoked, the industries, occupations, and professions with respect to which the certificates have been
most applicable, and the types of employers that have accepted the certificates. The department shall
annually create a report that summarizes the information maintained in the database and shall make
the report available to the public on its internet web site.
Sec. 4729.291. (A) Except when provided under section 4731.97 of the Revised Code, when
a licensed health professional authorized to prescribe drugs personally furnishes drugs to a patient
pursuant to division (B) of section 4729.29 of the Revised Code, the prescriber shall ensure that the
drugs are labeled and packaged in accordance with state and federal drug laws and any rules and
regulations adopted pursuant to those laws. Records of purchase and disposition of all drugs
personally furnished to patients shall be maintained by the prescriber in accordance with state and
federal drug statutes and any rules adopted pursuant to those statutes.
(B) When personally furnishing to a patient RU-486 (mifepristone), a prescriber is subject to
section sections 2919.123 and 2919.124 of the Revised Code. A prescription for RU-486
(mifepristone) shall be in writing and in accordance with section 2919.123 of the Revised Code.
(C)(1) Except as provided in divisions (D) and (E) of this section, no prescriber shall do
either of the following:
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(a) In any thirty-day period, personally furnish to or for patients, taken as a whole, controlled
substances in an amount that exceeds a total of two thousand five hundred dosage units;
(b) In any seventy-two-hour period, personally furnish to or for a patient an amount of a
controlled substance that exceeds the amount necessary for the patient's use in a seventy-two-hour
period.
(2) The state board of pharmacy may impose a fine of not more than five thousand dollars on
a prescriber who fails to comply with the limits established under division (C)(1) of this section. A
separate fine may be imposed for each instance of failing to comply with the limits. In imposing the
fine, the board's actions shall be taken in accordance with Chapter 119. of the Revised Code.
(D) None of the following shall be counted in determining whether the amounts specified in
division (C)(1) of this section have been exceeded:
(1) Methadone personally furnished to patients for the purpose of treating drug dependence or
addiction, if the prescriber meets the conditions specified in 21 C.F.R. 1306.07;
(2) Buprenorphine personally furnished to patients for the purpose of treating drug
dependence or addiction as part of an opioid treatment program licensed under section 5119.37 of the
Revised Code.
(3) Controlled substances personally furnished to research subjects by a facility conducting
clinical research in studies approved by a hospital-based institutional review board or an institutional
review board accredited by the association for the accreditation of human research protection
programs.
(E) Division (C)(1) of this section does not apply to a prescriber who is a veterinarian.
Sec. 4731.22. (A) The state medical board, by an affirmative vote of not fewer than six of its
members, may limit, revoke, or suspend a license or certificate to practice or certificate to
recommend, refuse to grant a license or certificate, refuse to renew a license or certificate, refuse to
reinstate a license or certificate, or reprimand or place on probation the holder of a license or
certificate if the individual applying for or holding the license or certificate is found by the board to
have committed fraud during the administration of the examination for a license or certificate to
practice or to have committed fraud, misrepresentation, or deception in applying for, renewing, or
securing any license or certificate to practice or certificate to recommend issued by the board.
(B) The board, by an affirmative vote of not fewer than six members, shall, to the extent
permitted by law, limit, revoke, or suspend a license or certificate to practice or certificate to
recommend, refuse to issue a license or certificate, refuse to renew a license or certificate, refuse to
reinstate a license or certificate, or reprimand or place on probation the holder of a license or
certificate for one or more of the following reasons:
(1) Permitting one's name or one's license or certificate to practice to be used by a person,
group, or corporation when the individual concerned is not actually directing the treatment given;
(2) Failure to maintain minimal standards applicable to the selection or administration of
drugs, or failure to employ acceptable scientific methods in the selection of drugs or other modalities
for treatment of disease;
(3) Except as provided in section 4731.97 of the Revised Code, selling, giving away,
personally furnishing, prescribing, or administering drugs for other than legal and legitimate
therapeutic purposes or a plea of guilty to, a judicial finding of guilt of, or a judicial finding of
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eligibility for intervention in lieu of conviction of, a violation of any federal or state law regulating
the possession, distribution, or use of any drug;
(4) Willfully betraying a professional confidence.
For purposes of this division, "willfully betraying a professional confidence" does not include
providing any information, documents, or reports under sections 307.621 to 307.629 of the Revised
Code to a child fatality review board; does not include providing any information, documents, or
reports to the director of health pursuant to guidelines established under section 3701.70 of the
Revised Code; does not include written notice to a mental health professional under section 4731.62
of the Revised Code; and does not include the making of a report of an employee's use of a drug of
abuse, or a report of a condition of an employee other than one involving the use of a drug of abuse,
to the employer of the employee as described in division (B) of section 2305.33 of the Revised Code.
Nothing in this division affects the immunity from civil liability conferred by section 2305.33 or
4731.62 of the Revised Code upon a physician who makes a report in accordance with section
2305.33 or notifies a mental health professional in accordance with section 4731.62 of the Revised
Code. As used in this division, "employee," "employer," and "physician" have the same meanings as
in section 2305.33 of the Revised Code.
(5) Making a false, fraudulent, deceptive, or misleading statement in the solicitation of or
advertising for patients; in relation to the practice of medicine and surgery, osteopathic medicine and
surgery, podiatric medicine and surgery, or a limited branch of medicine; or in securing or attempting
to secure any license or certificate to practice issued by the board.
As used in this division, "false, fraudulent, deceptive, or misleading statement" means a
statement that includes a misrepresentation of fact, is likely to mislead or deceive because of a failure
to disclose material facts, is intended or is likely to create false or unjustified expectations of
favorable results, or includes representations or implications that in reasonable probability will cause
an ordinarily prudent person to misunderstand or be deceived.
(6) A departure from, or the failure to conform to, minimal standards of care of similar
practitioners under the same or similar circumstances, whether or not actual injury to a patient is
established;
(7) Representing, with the purpose of obtaining compensation or other advantage as personal
gain or for any other person, that an incurable disease or injury, or other incurable condition, can be
permanently cured;
(8) The obtaining of, or attempting to obtain, money or anything of value by fraudulent
misrepresentations in the course of practice;
(9) A plea of guilty to, a judicial finding of guilt of, or a judicial finding of eligibility for
intervention in lieu of conviction for, a felony;
(10) Commission of an act that constitutes a felony in this state, regardless of the jurisdiction
in which the act was committed;
intervention in lieu of conviction for, a misdemeanor committed in the course of practice;
(12) Commission of an act in the course of practice that constitutes a misdemeanor in this
state, regardless of the jurisdiction in which the act was committed;
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intervention in lieu of conviction for, a misdemeanor involving moral turpitude;
(14) Commission of an act involving moral turpitude that constitutes a misdemeanor in this
state, regardless of the jurisdiction in which the act was committed;
(15) Violation of the conditions of limitation placed by the board upon a license or certificate
to practice;
(16) Failure to pay license renewal fees specified in this chapter;
(17) Except as authorized in section 4731.31 of the Revised Code, engaging in the division of
fees for referral of patients, or the receiving of a thing of value in return for a specific referral of a
patient to utilize a particular service or business;
(18) Subject to section 4731.226 of the Revised Code, violation of any provision of a code of
ethics of the American medical association, the American osteopathic association, the American
podiatric medical association, or any other national professional organizations that the board
specifies by rule. The state medical board shall obtain and keep on file current copies of the codes of
ethics of the various national professional organizations. The individual whose license or certificate
is being suspended or revoked shall not be found to have violated any provision of a code of ethics of
an organization not appropriate to the individual's profession.
For purposes of this division, a "provision of a code of ethics of a national professional
organization" does not include any provision that would preclude the making of a report by a
physician of an employee's use of a drug of abuse, or of a condition of an employee other than one
involving the use of a drug of abuse, to the employer of the employee as described in division (B) of
section 2305.33 of the Revised Code. Nothing in this division affects the immunity from civil
liability conferred by that section upon a physician who makes either type of report in accordance
with division (B) of that section. As used in this division, "employee," "employer," and "physician"
have the same meanings as in section 2305.33 of the Revised Code.
(19) Inability to practice according to acceptable and prevailing standards of care by reason
of mental illness or physical illness, including, but not limited to, physical deterioration that
adversely affects cognitive, motor, or perceptive skills.
In enforcing this division, the board, upon a showing of a possible violation, may compel any
individual authorized to practice by this chapter or who has submitted an application pursuant to this
chapter to submit to a mental examination, physical examination, including an HIV test, or both a
mental and a physical examination. The expense of the examination is the responsibility of the
individual compelled to be examined. Failure to submit to a mental or physical examination or
consent to an HIV test ordered by the board constitutes an admission of the allegations against the
individual unless the failure is due to circumstances beyond the individual's control, and a default and
final order may be entered without the taking of testimony or presentation of evidence. If the board
finds an individual unable to practice because of the reasons set forth in this division, the board shall
require the individual to submit to care, counseling, or treatment by physicians approved or
designated by the board, as a condition for initial, continued, reinstated, or renewed authority to
practice. An individual affected under this division shall be afforded an opportunity to demonstrate to
the board the ability to resume practice in compliance with acceptable and prevailing standards under
the provisions of the individual's license or certificate. For the purpose of this division, any individual
who applies for or receives a license or certificate to practice under this chapter accepts the privilege
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of practicing in this state and, by so doing, shall be deemed to have given consent to submit to a
mental or physical examination when directed to do so in writing by the board, and to have waived
all objections to the admissibility of testimony or examination reports that constitute a privileged
communication.
(20) Except as provided in division (F)(1)(b) of section 4731.282 of the Revised Code or
when civil penalties are imposed under section 4731.225 of the Revised Code, and subject to section
4731.226 of the Revised Code, violating or attempting to violate, directly or indirectly, or assisting in
or abetting the violation of, or conspiring to violate, any provisions of this chapter or any rule
promulgated by the board.
This division does not apply to a violation or attempted violation of, assisting in or abetting
the violation of, or a conspiracy to violate, any provision of this chapter or any rule adopted by the
board that would preclude the making of a report by a physician of an employee's use of a drug of
abuse, or of a condition of an employee other than one involving the use of a drug of abuse, to the
employer of the employee as described in division (B) of section 2305.33 of the Revised Code.
Nothing in this division affects the immunity from civil liability conferred by that section upon a
physician who makes either type of report in accordance with division (B) of that section. As used in
this division, "employee," "employer," and "physician" have the same meanings as in section
2305.33 of the Revised Code.
(21) The violation of section 3701.79 of the Revised Code or of any abortion rule adopted by
the director of health pursuant to section 3701.341 of the Revised Code;
(22) Any of the following actions taken by an agency responsible for authorizing, certifying,
or regulating an individual to practice a health care occupation or provide health care services in this
state or another jurisdiction, for any reason other than the nonpayment of fees: the limitation,
revocation, or suspension of an individual's license to practice; acceptance of an individual's license
surrender; denial of a license; refusal to renew or reinstate a license; imposition of probation; or
issuance of an order of censure or other reprimand;
(23) The violation of section 2919.12 of the Revised Code or the performance or inducement
of an abortion upon a pregnant woman with actual knowledge that the conditions specified in
division (B) of section 2317.56 of the Revised Code have not been satisfied or with a heedless
indifference as to whether those conditions have been satisfied, unless an affirmative defense as
specified in division (H)(2) of that section would apply in a civil action authorized by division (H)(1)
of that section;
(24) The revocation, suspension, restriction, reduction, or termination of clinical privileges by
the United States department of defense or department of veterans affairs or the termination or
suspension of a certificate of registration to prescribe drugs by the drug enforcement administration
of the United States department of justice;
(25) Termination or suspension from participation in the medicare or medicaid programs by
the department of health and human services or other responsible agency;
(26) Impairment of ability to practice according to acceptable and prevailing standards of
care because of habitual or excessive use or abuse of drugs, alcohol, or other substances that impair
ability to practice.
For the purposes of this division, any individual authorized to practice by this chapter accepts
S. B. No. 260 133rd G.A.
23
the privilege of practicing in this state subject to supervision by the board. By filing an application
for or holding a license or certificate to practice under this chapter, an individual shall be deemed to
have given consent to submit to a mental or physical examination when ordered to do so by the board
in writing, and to have waived all objections to the admissibility of testimony or examination reports
that constitute privileged communications.
If it has reason to believe that any individual authorized to practice by this chapter or any
applicant for licensure or certification to practice suffers such impairment, the board may compel the
individual to submit to a mental or physical examination, or both. The expense of the examination is
the responsibility of the individual compelled to be examined. Any mental or physical examination
required under this division shall be undertaken by a treatment provider or physician who is qualified
to conduct the examination and who is chosen by the board.
Failure to submit to a mental or physical examination ordered by the board constitutes an
admission of the allegations against the individual unless the failure is due to circumstances beyond
the individual's control, and a default and final order may be entered without the taking of testimony
or presentation of evidence. If the board determines that the individual's ability to practice is
impaired, the board shall suspend the individual's license or certificate or deny the individual's
application and shall require the individual, as a condition for initial, continued, reinstated, or
renewed licensure or certification to practice, to submit to treatment.
Before being eligible to apply for reinstatement of a license or certificate suspended under
this division, the impaired practitioner shall demonstrate to the board the ability to resume practice in
compliance with acceptable and prevailing standards of care under the provisions of the practitioner's
license or certificate. The demonstration shall include, but shall not be limited to, the following:
(a) Certification from a treatment provider approved under section 4731.25 of the Revised
Code that the individual has successfully completed any required inpatient treatment;
(b) Evidence of continuing full compliance with an aftercare contract or consent agreement;
(c) Two written reports indicating that the individual's ability to practice has been assessed
and that the individual has been found capable of practicing according to acceptable and prevailing
standards of care. The reports shall be made by individuals or providers approved by the board for
making the assessments and shall describe the basis for their determination.
The board may reinstate a license or certificate suspended under this division after that
demonstration and after the individual has entered into a written consent agreement.
When the impaired practitioner resumes practice, the board shall require continued
monitoring of the individual. The monitoring shall include, but not be limited to, compliance with the
written consent agreement entered into before reinstatement or with conditions imposed by board
order after a hearing, and, upon termination of the consent agreement, submission to the board for at
least two years of annual written progress reports made under penalty of perjury stating whether the
individual has maintained sobriety.
(27) A second or subsequent violation of section 4731.66 or 4731.69 of the Revised Code;
(28) Except as provided in division (N) of this section:
(a) Waiving the payment of all or any part of a deductible or copayment that a patient,
pursuant to a health insurance or health care policy, contract, or plan that covers the individual's
services, otherwise would be required to pay if the waiver is used as an enticement to a patient or
S. B. No. 260 133rd G.A.
24
group of patients to receive health care services from that individual;
(b) Advertising that the individual will waive the payment of all or any part of a deductible or
copayment that a patient, pursuant to a health insurance or health care policy, contract, or plan that
covers the individual's services, otherwise would be required to pay.
(29) Failure to use universal blood and body fluid precautions established by rules adopted
under section 4731.051 of the Revised Code;
(30) Failure to provide notice to, and receive acknowledgment of the notice from, a patient
when required by section 4731.143 of the Revised Code prior to providing nonemergency
professional services, or failure to maintain that notice in the patient's medical record;
(31) Failure of a physician supervising a physician assistant to maintain supervision in
accordance with the requirements of Chapter 4730. of the Revised Code and the rules adopted under
that chapter;
(32) Failure of a physician or podiatrist to enter into a standard care arrangement with a
clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner with whom the
physician or podiatrist is in collaboration pursuant to section 4731.27 of the Revised Code or failure
to fulfill the responsibilities of collaboration after entering into a standard care arrangement;
(33) Failure to comply with the terms of a consult agreement entered into with a pharmacist
pursuant to section 4729.39 of the Revised Code;
(34) Failure to cooperate in an investigation conducted by the board under division (F) of this
section, including failure to comply with a subpoena or order issued by the board or failure to answer
truthfully a question presented by the board in an investigative interview, an investigative office
conference, at a deposition, or in written interrogatories, except that failure to cooperate with an
investigation shall not constitute grounds for discipline under this section if a court of competent
jurisdiction has issued an order that either quashes a subpoena or permits the individual to withhold
the testimony or evidence in issue;
(35) Failure to supervise an oriental medicine practitioner or acupuncturist in accordance
with Chapter 4762. of the Revised Code and the board's rules for providing that supervision;
(36) Failure to supervise an anesthesiologist assistant in accordance with Chapter 4760. of the
Revised Code and the board's rules for supervision of an anesthesiologist assistant;
(37) Assisting suicide, as defined in section 3795.01 of the Revised Code;
(38) Failure to comply with the requirements of section 2317.561 of the Revised Code;
(39) Failure to supervise a radiologist assistant in accordance with Chapter 4774. of the
Revised Code and the board's rules for supervision of radiologist assistants;
(40) Performing or inducing an abortion at an office or facility with knowledge that the office
or facility fails to post the notice required under section 3701.791 of the Revised Code;
(41) Failure to comply with the standards and procedures established in rules under section
4731.054 of the Revised Code for the operation of or the provision of care at a pain management
clinic;
(42) Failure to comply with the standards and procedures established in rules under section
4731.054 of the Revised Code for providing supervision, direction, and control of individuals at a
pain management clinic;
(43) Failure to comply with the requirements of section 4729.79 or 4731.055 of the Revised
S. B. No. 260 133rd G.A.
25
Code, unless the state board of pharmacy no longer maintains a drug database pursuant to section
(44) Failure to comply with the requirements of section 2919.171, 2919.202, or 2919.203 of
the Revised Code or failure to submit to the department of health in accordance with a court order a
complete report as described in section 2919.171 or 2919.202 of the Revised Code;
(45) Practicing at a facility that is subject to licensure as a category III terminal distributor of
dangerous drugs with a pain management clinic classification unless the person operating the facility
has obtained and maintains the license with the classification;
(46) Owning a facility that is subject to licensure as a category III terminal distributor of
dangerous drugs with a pain management clinic classification unless the facility is licensed with the
classification;
(47) Failure to comply with any of the requirements regarding making or maintaining
medical records or documents described in division (A) of section 2919.192, division (C) of section
2919.193, division (B) of section 2919.195, or division (A) of section 2919.196 of the Revised Code;
(48) Failure to comply with the requirements in section 3719.061 of the Revised Code before
issuing for a minor a prescription for an opioid analgesic, as defined in section 3719.01 of the
Revised Code;
(49) Failure to comply with the requirements of section 4731.30 of the Revised Code or rules
adopted under section 4731.301 of the Revised Code when recommending treatment with medical
marijuana;
(50) Practicing at a facility, clinic, or other location that is subject to licensure as a category
III terminal distributor of dangerous drugs with an office-based opioid treatment classification unless
the person operating that place has obtained and maintains the license with the classification;
(51) Owning a facility, clinic, or other location that is subject to licensure as a category III
terminal distributor of dangerous drugs with an office-based opioid treatment classification unless
that place is licensed with the classification;
(52) A pattern of continuous or repeated violations of division (E)(2) or (3) of section
(C) Disciplinary actions taken by the board under divisions (A) and (B) of this section shall
be taken pursuant to an adjudication under Chapter 119. of the Revised Code, except that in lieu of an
adjudication, the board may enter into a consent agreement with an individual to resolve an
allegation of a violation of this chapter or any rule adopted under it. A consent agreement, when
ratified by an affirmative vote of not fewer than six members of the board, shall constitute the
findings and order of the board with respect to the matter addressed in the agreement. If the board
refuses to ratify a consent agreement, the admissions and findings contained in the consent agreement
shall be of no force or effect.
A telephone conference call may be utilized for ratification of a consent agreement that
revokes or suspends an individual's license or certificate to practice or certificate to recommend. The
telephone conference call shall be considered a special meeting under division (F) of section 121.22
of the Revised Code.
If the board takes disciplinary action against an individual under division (B) of this section
for a second or subsequent plea of guilty to, or judicial finding of guilt of, a violation of section
S. B. No. 260 133rd G.A.
26
2919.123 or 2919.124 of the Revised Code, the disciplinary action shall consist of a suspension of
the individual's license or certificate to practice for a period of at least one year or, if determined
appropriate by the board, a more serious sanction involving the individual's license or certificate to
practice. Any consent agreement entered into under this division with an individual that pertains to a
second or subsequent plea of guilty to, or judicial finding of guilt of, a violation of that section shall
provide for a suspension of the individual's license or certificate to practice for a period of at least
one year or, if determined appropriate by the board, a more serious sanction involving the
individual's license or certificate to practice.
(D) For purposes of divisions (B)(10), (12), and (14) of this section, the commission of the
act may be established by a finding by the board, pursuant to an adjudication under Chapter 119. of
the Revised Code, that the individual committed the act. The board does not have jurisdiction under
those divisions if the trial court renders a final judgment in the individual's favor and that judgment is
based upon an adjudication on the merits. The board has jurisdiction under those divisions if the trial
court issues an order of dismissal upon technical or procedural grounds.
(E) The sealing of conviction records by any court shall have no effect upon a prior board
order entered under this section or upon the board's jurisdiction to take action under this section if,
based upon a plea of guilty, a judicial finding of guilt, or a judicial finding of eligibility for
intervention in lieu of conviction, the board issued a notice of opportunity for a hearing prior to the
court's order to seal the records. The board shall not be required to seal, destroy, redact, or otherwise
modify its records to reflect the court's sealing of conviction records.
(F)(1) The board shall investigate evidence that appears to show that a person has violated
any provision of this chapter or any rule adopted under it. Any person may report to the board in a
signed writing any information that the person may have that appears to show a violation of any
provision of this chapter or any rule adopted under it. In the absence of bad faith, any person who
reports information of that nature or who testifies before the board in any adjudication conducted
under Chapter 119. of the Revised Code shall not be liable in damages in a civil action as a result of
the report or testimony. Each complaint or allegation of a violation received by the board shall be
assigned a case number and shall be recorded by the board.
(2) Investigations of alleged violations of this chapter or any rule adopted under it shall be
supervised by the supervising member elected by the board in accordance with section 4731.02 of the
Revised Code and by the secretary as provided in section 4731.39 of the Revised Code. The president
may designate another member of the board to supervise the investigation in place of the supervising
member. No member of the board who supervises the investigation of a case shall participate in
further adjudication of the case.
(3) In investigating a possible violation of this chapter or any rule adopted under this chapter,
or in conducting an inspection under division (E) of section 4731.054 of the Revised Code, the board
may question witnesses, conduct interviews, administer oaths, order the taking of depositions, inspect
and copy any books, accounts, papers, records, or documents, issue subpoenas, and compel the
attendance of witnesses and production of books, accounts, papers, records, documents, and
testimony, except that a subpoena for patient record information shall not be issued without
consultation with the attorney general's office and approval of the secretary and supervising member
of the board.
S. B. No. 260 133rd G.A.
27
(a) Before issuance of a subpoena for patient record information, the secretary and
supervising member shall determine whether there is probable cause to believe that the complaint
filed alleges a violation of this chapter or any rule adopted under it and that the records sought are
relevant to the alleged violation and material to the investigation. The subpoena may apply only to
records that cover a reasonable period of time surrounding the alleged violation.
(b) On failure to comply with any subpoena issued by the board and after reasonable notice to
the person being subpoenaed, the board may move for an order compelling the production of persons
or records pursuant to the Rules of Civil Procedure.
(c) A subpoena issued by the board may be served by a sheriff, the sheriff's deputy, or a board
employee or agent designated by the board. Service of a subpoena issued by the board may be made
by delivering a copy of the subpoena to the person named therein, reading it to the person, or leaving
it at the person's usual place of residence, usual place of business, or address on file with the board.
When serving a subpoena to an applicant for or the holder of a license or certificate issued under this
chapter, service of the subpoena may be made by certified mail, return receipt requested, and the
subpoena shall be deemed served on the date delivery is made or the date the person refuses to accept
delivery. If the person being served refuses to accept the subpoena or is not located, service may be
made to an attorney who notifies the board that the attorney is representing the person.
(d) A sheriff's deputy who serves a subpoena shall receive the same fees as a sheriff. Each
witness who appears before the board in obedience to a subpoena shall receive the fees and mileage
provided for under section 119.094 of the Revised Code.
(4) All hearings, investigations, and inspections of the board shall be considered civil actions
for the purposes of section 2305.252 of the Revised Code.
(5) A report required to be submitted to the board under this chapter, a complaint, or
information received by the board pursuant to an investigation or pursuant to an inspection under
division (E) of section 4731.054 of the Revised Code is confidential and not subject to discovery in
any civil action.
The board shall conduct all investigations or inspections and proceedings in a manner that
protects the confidentiality of patients and persons who file complaints with the board. The board
shall not make public the names or any other identifying information about patients or complainants
unless proper consent is given or, in the case of a patient, a waiver of the patient privilege exists
under division (B) of section 2317.02 of the Revised Code, except that consent or a waiver of that
nature is not required if the board possesses reliable and substantial evidence that no bona fide
physician-patient relationship exists.
The board may share any information it receives pursuant to an investigation or inspection,
including patient records and patient record information, with law enforcement agencies, other
licensing boards, and other governmental agencies that are prosecuting, adjudicating, or investigating
alleged violations of statutes or administrative rules. An agency or board that receives the
information shall comply with the same requirements regarding confidentiality as those with which
the state medical board must comply, notwithstanding any conflicting provision of the Revised Code
or procedure of the agency or board that applies when it is dealing with other information in its
possession. In a judicial proceeding, the information may be admitted into evidence only in
accordance with the Rules of Evidence, but the court shall require that appropriate measures are
S. B. No. 260 133rd G.A.
28
taken to ensure that confidentiality is maintained with respect to any part of the information that
contains names or other identifying information about patients or complainants whose confidentiality
was protected by the state medical board when the information was in the board's possession.
Measures to ensure confidentiality that may be taken by the court include sealing its records or
deleting specific information from its records.
(6) On a quarterly basis, the board shall prepare a report that documents the disposition of all
cases during the preceding three months. The report shall contain the following information for each
case with which the board has completed its activities:
(a) The case number assigned to the complaint or alleged violation;
(b) The type of license or certificate to practice, if any, held by the individual against whom
the complaint is directed;
(c) A description of the allegations contained in the complaint;
(d) The disposition of the case.
The report shall state how many cases are still pending and shall be prepared in a manner that
protects the identity of each person involved in each case. The report shall be a public record under
section 149.43 of the Revised Code.
(G) If the secretary and supervising member determine both of the following, they may
recommend that the board suspend an individual's license or certificate to practice or certificate to
recommend without a prior hearing:
(1) That there is clear and convincing evidence that an individual has violated division (B) of
this section;
(2) That the individual's continued practice presents a danger of immediate and serious harm
to the public.
Written allegations shall be prepared for consideration by the board. The board, upon review
of those allegations and by an affirmative vote of not fewer than six of its members, excluding the
secretary and supervising member, may suspend a license or certificate without a prior hearing. A
telephone conference call may be utilized for reviewing the allegations and taking the vote on the
summary suspension.
The board shall issue a written order of suspension by certified mail or in person in
accordance with section 119.07 of the Revised Code. The order shall not be subject to suspension by
the court during pendency of any appeal filed under section 119.12 of the Revised Code. If the
individual subject to the summary suspension requests an adjudicatory hearing by the board, the date
set for the hearing shall be within fifteen days, but not earlier than seven days, after the individual
requests the hearing, unless otherwise agreed to by both the board and the individual.
Any summary suspension imposed under this division shall remain in effect, unless reversed
on appeal, until a final adjudicative order issued by the board pursuant to this section and Chapter
119. of the Revised Code becomes effective. The board shall issue its final adjudicative order within
seventy-five days after completion of its hearing. A failure to issue the order within seventy-five days
shall result in dissolution of the summary suspension order but shall not invalidate any subsequent,
final adjudicative order.
(H) If the board takes action under division (B)(9), (11), or (13) of this section and the
judicial finding of guilt, guilty plea, or judicial finding of eligibility for intervention in lieu of
S. B. No. 260 133rd G.A.
29
conviction is overturned on appeal, upon exhaustion of the criminal appeal, a petition for
reconsideration of the order may be filed with the board along with appropriate court documents.
Upon receipt of a petition of that nature and supporting court documents, the board shall reinstate the
individual's license or certificate to practice. The board may then hold an adjudication under Chapter
119. of the Revised Code to determine whether the individual committed the act in question. Notice
of an opportunity for a hearing shall be given in accordance with Chapter 119. of the Revised Code.
If the board finds, pursuant to an adjudication held under this division, that the individual committed
the act or if no hearing is requested, the board may order any of the sanctions identified under
division (B) of this section.
(I) The license or certificate to practice issued to an individual under this chapter and the
individual's practice in this state are automatically suspended as of the date of the individual's second
or subsequent plea of guilty to, or judicial finding of guilt of, a violation of section 2919.123 or
2919.124 of the Revised Code. In addition, the license or certificate to practice or certificate to
recommend issued to an individual under this chapter and the individual's practice in this state are
automatically suspended as of the date the individual pleads guilty to, is found by a judge or jury to
be guilty of, or is subject to a judicial finding of eligibility for intervention in lieu of conviction in
this state or treatment or intervention in lieu of conviction in another jurisdiction for any of the
following criminal offenses in this state or a substantially equivalent criminal offense in another
jurisdiction: aggravated murder, murder, voluntary manslaughter, felonious assault, kidnapping, rape,
sexual battery, gross sexual imposition, aggravated arson, aggravated robbery, or aggravated
burglary. Continued practice after suspension shall be considered practicing without a license or
certificate.
The board shall notify the individual subject to the suspension by certified mail or in person
in accordance with section 119.07 of the Revised Code. If an individual whose license or certificate
is automatically suspended under this division fails to make a timely request for an adjudication
under Chapter 119. of the Revised Code, the board shall do whichever of the following is applicable:
(1) If the automatic suspension under this division is for a second or subsequent plea of guilty
to, or judicial finding of guilt of, a violation of section 2919.123 or 2919.124 of the Revised Code,
the board shall enter an order suspending the individual's license or certificate to practice for a period
of at least one year or, if determined appropriate by the board, imposing a more serious sanction
involving the individual's license or certificate to practice.
(2) In all circumstances in which division (I)(1) of this section does not apply, enter a final
order permanently revoking the individual's license or certificate to practice.
(J) If the board is required by Chapter 119. of the Revised Code to give notice of an
opportunity for a hearing and if the individual subject to the notice does not timely request a hearing
in accordance with section 119.07 of the Revised Code, the board is not required to hold a hearing,
but may adopt, by an affirmative vote of not fewer than six of its members, a final order that contains
the board's findings. In that final order, the board may order any of the sanctions identified under
division (A) or (B) of this section.
(K) Any action taken by the board under division (B) of this section resulting in a suspension
from practice shall be accompanied by a written statement of the conditions under which the
individual's license or certificate to practice may be reinstated. The board shall adopt rules governing
S. B. No. 260 133rd G.A.
30
conditions to be imposed for reinstatement. Reinstatement of a license or certificate suspended
pursuant to division (B) of this section requires an affirmative vote of not fewer than six members of
the board.
(L) When the board refuses to grant or issue a license or certificate to practice to an applicant,
revokes an individual's license or certificate to practice, refuses to renew an individual's license or
certificate to practice, or refuses to reinstate an individual's license or certificate to practice, the board
may specify that its action is permanent. An individual subject to a permanent action taken by the
board is forever thereafter ineligible to hold a license or certificate to practice and the board shall not
accept an application for reinstatement of the license or certificate or for issuance of a new license or
certificate.
(M) Notwithstanding any other provision of the Revised Code, all of the following apply:
(1) The surrender of a license or certificate issued under this chapter shall not be effective
unless or until accepted by the board. A telephone conference call may be utilized for acceptance of
the surrender of an individual's license or certificate to practice. The telephone conference call shall
be considered a special meeting under division (F) of section 121.22 of the Revised Code.
Reinstatement of a license or certificate surrendered to the board requires an affirmative vote of not
fewer than six members of the board.
(2) An application for a license or certificate made under the provisions of this chapter may
not be withdrawn without approval of the board.
(3) Failure by an individual to renew a license or certificate to practice in accordance with
this chapter or a certificate to recommend in accordance with rules adopted under section 4731.301
of the Revised Code shall not remove or limit the board's jurisdiction to take any disciplinary action
under this section against the individual.
(4) At the request of the board, a license or certificate holder shall immediately surrender to
the board a license or certificate that the board has suspended, revoked, or permanently revoked.
(N) Sanctions shall not be imposed under division (B)(28) of this section against any person
who waives deductibles and copayments as follows:
(1) In compliance with the health benefit plan that expressly allows such a practice. Waiver of
the deductibles or copayments shall be made only with the full knowledge and consent of the plan
purchaser, payer, and third-party administrator. Documentation of the consent shall be made available
to the board upon request.
(2) For professional services rendered to any other person authorized to practice pursuant to
this chapter, to the extent allowed by this chapter and rules adopted by the board.
(O) Under the board's investigative duties described in this section and subject to division (F)
of this section, the board shall develop and implement a quality intervention program designed to
improve through remedial education the clinical and communication skills of individuals authorized
under this chapter to practice medicine and surgery, osteopathic medicine and surgery, and podiatric
medicine and surgery. In developing and implementing the quality intervention program, the board
may do all of the following:
(1) Offer in appropriate cases as determined by the board an educational and assessment
program pursuant to an investigation the board conducts under this section;
(2) Select providers of educational and assessment services, including a quality intervention
S. B. No. 260 133rd G.A.
31
program panel of case reviewers;
(3) Make referrals to educational and assessment service providers and approve individual
educational programs recommended by those providers. The board shall monitor the progress of each
individual undertaking a recommended individual educational program.
(4) Determine what constitutes successful completion of an individual educational program
and require further monitoring of the individual who completed the program or other action that the
board determines to be appropriate;
(5) Adopt rules in accordance with Chapter 119. of the Revised Code to further implement
the quality intervention program.
An individual who participates in an individual educational program pursuant to this division
shall pay the financial obligations arising from that educational program.
Sec. 4731.223. (A) As used in this section, "prosecutor" has the same meaning as in section
(B) Whenever any person holding a valid license or certificate issued pursuant to this chapter
pleads guilty to, is subject to a judicial finding of guilt of, or is subject to a judicial finding of
eligibility for intervention in lieu of conviction for a violation of Chapter 2907., 2925., or 3719. of
the Revised Code or of any substantively comparable ordinance of a municipal corporation in
connection with the person's practice, or for a second or subsequent time pleads guilty to, or is
subject to a judicial finding of guilt of, a violation of section 2919.123 or 2919.124 of the Revised
Code, the prosecutor in the case, on forms prescribed and provided by the state medical board, shall
promptly notify the board of the conviction or guilty plea. Within thirty days of receipt of that
information, the board shall initiate action in accordance with Chapter 119. of the Revised Code to
determine whether to suspend or revoke the license or certificate under section 4731.22 of the
Revised Code.
(C) The prosecutor in any case against any person holding a valid license or certificate issued
pursuant to this chapter, on forms prescribed and provided by the state medical board, shall notify the
board of any of the following:
(1) A plea of guilty to, a finding of guilt by a jury or court of, or judicial finding of eligibility
for intervention in lieu of conviction for a felony, or a case in which the trial court issues an order of
dismissal upon technical or procedural grounds of a felony charge;
for intervention in lieu of conviction for a misdemeanor committed in the course of practice, or a case
in which the trial court issues an order of dismissal upon technical or procedural grounds of a charge
of a misdemeanor, if the alleged act was committed in the course of practice;
for intervention in lieu of conviction for a misdemeanor involving moral turpitude, or a case in which
the trial court issues an order of dismissal upon technical or procedural grounds of a charge of a
misdemeanor involving moral turpitude.
The report shall include the name and address of the license or certificate holder, the nature
of the offense for which the action was taken, and the certified court documents recording the action.
SECTION 2. That existing sections 109.572, 2919.123, 2953.25, 4729.291, 4731.22, and
S. B. No. 260 133rd G.A.
32
4731.223 of the Revised Code are hereby repealed.
SECTION 3. Section 109.572 of the Revised Code is presented in this act as a composite of the
section as amended by both H.B. 166 and S.B. 57 of the 133rd General Assembly. The General
Assembly, applying the principle stated in division (B) of section 1.52 of the Revised Code that
amendments are to be harmonized if reasonably capable of simultaneous operation, finds that the
composite is the resulting version of the section in effect prior to the effective date of the section as
presented in this act.
S. B. No. 260 133rd G.A.
33
Speaker ___________________ of the House of Representatives.
President ___________________ of the Senate.
Passed ________________________, 20____
Approved ________________________, 20____
Governor.
S. B. No. 260 133rd G.A.
34
The section numbering of law of a general and permanent nature is

complete and in conformity with the Revised Code.
Director, Legislative Service Commission.
Filed in the office of the Secretary of State at Columbus, Ohio, on the ____
day of ___________, A. D. 20____.
Secretary of State.
File No. _________ Effective Date ___________________

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Ohio Administrative Code
Rule 4723-9-10 Formulary; standards of prescribing for advanced practice
registered nurses designated as clinical nurse specialists, certified nurse-
midwives, or certified nurse practitioners.
Effective: February 1, 2022
(A) Definitions; for purposes of this rule and interpretation of the formulary set forth in paragraph
(B) of this rule, except as otherwise provided:
(1) "Acute pain" means pain that normally fades with healing, is related to tissue damage,
significantly alters a patient's typical function, and is expected to be time-limited and not more than
six weeks in duration.
(2) "Chronic pain" means pain that has persisted after reasonable medical efforts have been made to
relieve it and continues either episodically or continuously for twelve or more weeks following
initial onset of pain. It may be the result of an underlying medical disease or condition, injury,
medical treatment, inflammation, or unknown cause. "Chronic pain" does not include pain associated
with a terminal condition or with a progressive disease that, in the normal course of progression, may
reasonably be expected to result in a terminal condition.
(3) "Extended-release or long-acting opioid analgesic" means an opioid analgesic that:
(a) Has United States food and drug administration approved labeling indicating that it is an
extended-release or controlled release formulation;
(b) Is administered via a transdermal route; or
(c) Contains methadone.
(4) "Family member" means a spouse, parent, child, sibling or other individual with respect to whom
an advanced practice registered nurse's personal or emotional involvement may render the advanced
practice registered nurse unable to exercise detached professional judgment in reaching diagnostic or
therapeutic decisions.
Page 1
(5) "Hospice care program" has the same meaning as in section 3712.01 of the Revised Code.
(6) "ICD-10-CM medical diagnosis code" means the disease code in the most current international
classification of diseases, clinical modifications published by the United States department of health
and human services.
(7) "Opioid analgesic" has the same meaning as in section 3719.01 of the Revised Code, and means a
controlled substance that has analgesic pharmacological activity at the opioid receptors of the central
nervous system, including but not limited to the following drugs and their varying salt forms or
chemical congeners: buprenorphine, butorphanol, codeine (including acetaminophen and other
combination products), dihydrocodeine, fentanyl, hydrocodone (including acetaminophen
combination products), hydromorphone, meperidine, methadone, morphine sulfate, oxycodone
(including acetaminophen, aspirin, and other combination products), oxymorphone, tapentadol, and
tramadol.
(8) "Medication therapy management" has the same meaning as in rules adopted by agency 4729 of
the Administrative Code.
(9) "Minor" has the same meaning as in section 3719.061 of the Revised Code.
(10) "Morphine equivalent daily dose (MED)" means a conversion of various opioid analgesics to a
morphine equivalent dose by the use of accepted conversion tables provided by the state board of
pharmacy at: https://www.ohiopmp.gov/MED_Calculator.aspx (effective 2017).
(11) "Palliative care" has the same meaning as in section 3712.01 of the Revised Code.
(12) "Sub-acute pain" means pain that has persisted after reasonable medical efforts have been made
to relieve it and continues either episodically or continuously for more than six weeks but less than
twelve weeks following initial onset of pain. It may be the result of an underlying medical disease or
condition, injury, medical or surgical treatment, inflammation, or unknown cause.
(13) "Terminal condition" has the same meaning as in section 2133.01 of the Revised Code.
Page 2
(B) Exclusionary formulary. An advanced practice registered nurse with a current valid license
issued by the board and designated as a certified nurse practitioner, clinical nurse specialist or
certified nurse midwife shall not prescribe or furnish any drug or device in violation of federal or
Ohio law, or rules adopted by the board, including this rule. The prescriptive authority of an
advanced practice registered nurse designated as a certified nurse practitioner, clinical nurse
specialist and certified nurse midwife shall not exceed the prescriptive authority of the collaborating
physician or podiatrist.
(C) An advanced practice registered nurse with a current valid license issued by the board and
designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may
prescribe any drug or therapeutic device in any form or route of administration if:
(1) The ability to prescribe the drug or therapeutic device is within the scope of practice in the
advanced practice registered nurse's license designation;
(2) The prescription is consistent with the terms of a standard care arrangement entered into with a
collaborating physician;
(3) The prescription would not exceed the prescriptive authority of the collaborating physician,
including restrictions imposed on the physician's practice by action of the United States drug
enforcement administration or the state medical board, or by the state medical board rules, including
but not limited to rule 4731-11-09 of the Administrative Code;
(4) The individual drug or subtype or therapeutic device is not one excluded by the exclusionary
formulary set forth in paragraph (B ) of this rule;
(5) The prescription meets the requirements of state and federal law, including but not limited to this
rule, and all prescription issuance rules adopted by agency 4729 of the Administrative Code;
(6) A valid prescriber-patient relationship exists. This relationship may include, but is not limited to:
(a) Obtaining a relevant history of the patient;
Page 3
(b) Conducting a physical or mental examination of the patient;
(c) Rendering a diagnosis;
(d) Prescribing medication;
(e) Consulting with the collaborating physician when necessary; and
(f) Documenting these steps in the patient's medical records;
(7) Notwithstanding paragraph (C)(6) of this rule, a clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner may prescribe or personally furnish a drug according to section
4723.4810 of the Revised Code to not more than a total of two individuals who are sexual partners of
the advanced practice registered nurse's patient.
(8) If the patient is a family member, acceptable and prevailing standards of safe nursing care require
that the advanced practice registered nurse maintain detached professional judgment. The advanced
practice registered nurse shall not prescribe to a family member unless:
(a) The advanced practice registered nurse is able to exercise detached professional judgment in
reaching diagnostic or therapeutic decisions;
(b) The prescription is documented in the patient's record.
(9) Controlled substances. For drugs that are a controlled substance:
(a) The advanced practice registered nurse has obtained a United States drug enforcement
administration registration, except if not required to do so as provided in rules adopted by agency
4729 of the Administrative Code, and indicates the number on the prescription;
(b) The prescription indicates the ICD-10-CM medical diagnosis code of the primary disease or
condition that the controlled substance is being used to treat. The code shall, at minimum, include the
Page 4
first four alphanumeric characters of the ICD-10 CM medical diagnosis code, sometimes referred to
as the category and etiology (ex. M165);
(c) The prescription indicates the days' supply of the controlled substance prescription.
(d) The patient is not a family member; and
(e) The advanced practice registered nurse shall not self-prescribe a controlled substance.
(D) Schedule II controlled substances. Except as provided in paragraph (E) of this rule, an advanced
practice registered nurse with a current valid license issued by the board and designated as a clinical
nurse specialist, certified nurse-midwife, or certified nurse practitioner may prescribe a schedule II
controlled substance only in situations where all of the following apply:
(1) A patient has a terminal condition;
(2) A physician initially prescribed the substance for the patient; and
(3) The prescription is for a quantity that does not exceed the amount necessary for the patient's use
in a single, seventy-two hour period.
(E) Subject to the requirements set forth in paragraphs (F), , and (J) of this rule, a clinical nurse
specialist, certified nurse-midwife, or certified nurse practitioner may prescribe a schedule II
controlled substance, if not excluded by the exclusionary formulary set forth in paragraph (B) of this
rule, if the advanced practice registered nurse issues the prescription to the patient from any of the
following locations:
(1) A hospital registered under section 3701.07 of the Revised Code;
(2) An entity owned or controlled, in whole or in part, by a hospital or by an entity that owns or
controls, in whole or in part, one or more hospitals;
(3) A health care facility operated by the department of mental health or the department of
Page 5
developmental disabilities;
(4) A nursing home licensed under section 3721.02 of the Revised Code or by a political subdivision
certified under section 3721.09 of the Revised Code;
(5) A county home or district home operated under Chapter 5155. of the Revised Code that is
certified under the medicare or medicaid program;
(6) A hospice care program;
(7) A community mental health agency, as defined in section 5122.01 of the Revised Code;
(8) An ambulatory surgical facility, as defined in section 3702.30 of the Revised Code;
(9) A freestanding birthing center, as defined in section 3702.141 of the Revised Code;
(10) A federally qualified health center, as defined in section 3701.047 of the Revised Code;
(11) A federally qualified health center look-alike, as defined in section 3701.047 of the Revised
Code;
(12) A health care office or facility operated by the board of health of a city or general health district
or the authority having the duties of a board of health under section 3709.05 of the Revised Code;
(13) A site where a medical practice is operated, but only if the practice is comprised of one or more
physicians who also are owners of the practice; the practice is organized to provide direct patient
care; and the clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner
providing services at the site has a standard care arrangement and collaborates with at least one of
the physician owners who practices primarily at that site; or
(14) A residential care facility, as defined in section 3721.01 of the Revised Code.
(F) An advanced practice registered nurse with a current valid license issued by the board and
Page 6
designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall
not issue to a patient a prescription for a schedule II controlled substance from a convenience care
clinic even if the clinic is owned or operated by an entity specified in paragraph (E) of this rule.
(G) Acute pain. For the treatment of acute pain, an advanced practice registered nurse with a current
valid license issued by the board and designated as a clinical nurse specialist, certified nurse-
midwife, or certified nurse practitioner shall comply with the following:
(1) Extended-release or long-acting opioid analgesics shall not be prescribed for the treatment of
acute pain;
(2) Before prescribing an opioid analgesic, the advanced practice registered nurse shall first consider
non-opioid treatment options. If opioid analgesic medications are required as determined by history
and physical examination, the prescription should be for the minimum quantity and potency needed
to treat the expected duration of pain, with a presumption that a three-day supply or less is frequently
sufficient;
(3) In all circumstances where opioid analgesics are prescribed for acute pain:
(a) Except as provided in paragraph (G)(3)(a)(iii) of this rule, the duration of the first opioid
analgesic prescription for the treatment of an episode of acute pain shall be:
(i) For adults, not more than a seven-day supply with no refills;
(ii) For minors, not more than a five-day supply with no refills. As set forth in section 4723.481 of
the Revised Code, the advanced practice registered nurse shall comply with section 3719.061 of the
Revised Code, including but not limited to obtaining the parent or guardian's written consent prior to
prescribing an opioid analgesic to a minor;
(iii) The seven-day limit for adults and five-day limit for minors may be exceeded for pain that is
expected to persist for longer than seven days based on the pathology causing the pain. In this
circumstance, the reason that the limits are being exceeded and the reason that a non-opioid
analgesic medication was not appropriate to treat the patient's condition shall be documented in the
Page 7
patient's medical record; and
(iv) If a patient is intolerant of or allergic to an opioid medication initially prescribed, a prescription

for a different opioid medication may be issued at any time during the initial seven-day or five-day
dosing period, and the new prescription shall be subject to the requirements of this rule. The patient's
intolerance or allergy shall be documented in the patient's medical record, and the patient advised to
safely dispose of the unused medication;
(b) The patient, or a minor's parent or guardian, shall be advised of the benefits and risks of the
opioid analgesic, including the potential for addiction, and the advice shall be documented in the
patient's medical record; and
(c) The total morphine equivalent dose (MED) of a prescription for opioid analgesics for treatment of
acute pain shall not exceed an average of thirty MED per day, except when:
(i) The circumstances set forth in paragraph (A)(3)(c) of rule 4731-11-13 of the Administrative Code
exist; and
(ii) The patient's treating physician has entered a standard care arrangement with the advanced
practice registered nurse that states the understanding of the physician as to when the advanced
practice registered nurse may exceed the thirty MED average, and when the advanced practice
registered nurse must consult with the physician prior to exceeding the thirty MED average. The
standard care arrangement in this circumstance must comply with rule 4731-11-13 of the
Administrative Code, and the advanced practice registered nurse must document in the patient's
record the reason for exceeding the thirty MED average and the reason it is the lowest dose
consistent with the patient's medical condition.
(H) The requirements of paragraph (G) of this rule apply to treatment of acute pain, and do not apply
when an opioid analgesic is prescribed:
(1) To a patient in a hospice care;
(2) To a patient who is receiving palliative care;
Page 8
(3) To a patient who has been diagnosed with a terminal condition, as defined as follows:
(a) An irreversible, incurable, and untreatable condition caused by disease, illness, or injury from
which, to a reasonable degree of medical certainty as determined in accordance with reasonable
medical standards by a physician who has examined the patient, both of the following apply:
(i) There can be no recovery; and
(ii) Death is likely to occur within a relatively short time if life-sustaining treatment is not
administered; or
(4) To a patient who has cancer or a condition associated with the individual's cancer or history of
cancer.
(I) The requirements of paragraph (G) of this rule do not apply to:
(1) Prescriptions for opioid analgesics for the treatment of opioid addiction utilizing a controlled
substance that is approved by the FDA for opioid detoxification or maintenance treatment; or
(2) Inpatient prescriptions as defined in rules adopted by agency 4729 of the Administrative Code.
(J) Sub-acute and chronic pain. As specified in section 4723.481 of the Revised Code, for treatment
of sub-acute and chronic pain, an advanced practice registered nurse with a current valid license
issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified
nurse practitioner shall prescribe in a manner not exceeding the prescriptive authority of the
collaborating physician or podiatrist. Prescribing parameters specifically include, but are not limited
to, the following requirements set forth in rule 4731-11-14 of the Administrative Code:
(1) Prior to treating, or continuing to treat sub-acute or chronic pain with an opioid analgesic, the
advanced practice registered nurse shall first consider and document non-medication options. If
opioid analgesic medications are required as determined by a history and physical examination, the
advanced practice registered nurse shall prescribe the minimum quantity and potency needed to treat
Page 9
the expected duration of pain and improve the patient's ability to function;
(2) Before prescribing an opioid analgesic for sub-acute or chronic pain, the advanced practice
registered nurse shall complete or update and document in the patient record assessment activities to
assure the appropriateness and safety of the medication, as required by rule 4731-11-14 of the
Administrative Code, including but not limited to:
(a) Completing an OARRS check in compliance with rule 4723-9-12 of the Administrative Code;
(b) Offering the patient a prescription for naloxone if the following circumstances exist:
(i) The patient has a prior history of opioid overdose;
(ii) The patient is co-prescribed a benzodiazepine, sedative hypnotic drug, carisprodal, tramadol, or
gabapentin;
(iii) The patient has a concurrent substance use disorder; or
(iv) The dosage exceeds eighty MED as discussed in paragraph (J)(5) of this rule;
(c) The advanced practice registered nurse shall consider offering the patient a prescription for
naloxone if the dosage exceeds fifty MED as discussed in paragraph (J)(4) of this rule.
(3) During the course of treatment with an opioid analgesic at doses below the average of fifty MED
per day, the advanced practice registered nurse shall provide periodic follow-up assessment and
documentation of the patient's functional status, the patient's progress toward treatment objectives,
indicators of possible addiction, drug abuse or diversion, and any adverse drug effects.
(4) Fifty MED. Prior to increasing the opioid dosage to a daily average of fifty MED or greater, the
advanced practice registered nurse shall complete and document in the patient record the activities
and information set forth in rule 4731-11-14 of the Administrative Code, including but not limited to
the following:
Page 10
(a) Review and update the assessment completed in paragraph (J)(2) of this rule if needed. The
advanced practice registered nurse may rely on an appropriate assessment completed within a
reasonable time if the advanced practice registered nurse is satisfied that he or she may rely on that
information for purposes of meeting the requirements of Chapter 4723-8 and Chapter 4723-9 of the
Administrative Code;
(b) Except when the patient was prescribed an average daily dosage that exceeded fifty MED before
the effective date of this rule, document consideration of:
(i) Consultation with a specialist in the area of the body affected by the pain;
(ii) Consultation with a pain management specialist;
(iii) Obtaining a medication therapy management review by a pharmacist;
(iv) Consultation with a specialist in addiction medicine or addiction psychiatry, if aberrant

behaviors indicating medication misuse or substance use disorder are noted;
(c) The advanced practice registered nurse shall consider offering the patient a prescription for
naloxone if the dosage exceeds fifty MED as discussed in paragraph (J)(4) of this rule;
(d) During the course of treatment with an opioid analgesic at doses at or above the average of fifty
MED per day, the advanced practice registered nurse shall complete and document in the patient
record all of the information and activities required by rule 4731-11-14 of the Administrative Code
not less than every three months.
(5) Eighty MED. Prior to increasing the opioid dosage to a daily average of eighty MED or greater,
the advanced practice registered nurse shall complete and document in the patient record the
activities and information set forth in rule 4731-11-14 of the Administrative Code, including but not
limited to the following:
(a) A written pain management agreement shall be entered with the patient that outlines the advanced
practice registered nurse's and patient's responsibilities during treatment, which requires the patient
Page 11
or patient guardian's agreement to all of the provisions set forth in rule 4731-11-14 of the
Administrative Code;
(b) The advanced practice registered nurse shall offer the patient a prescription for naloxone;
(c) Except when the patient was prescribed an average daily dosage that exceeded eighty MED
before the effective date of this rule, the advanced practice registered nurse shall obtain at least one
of the following based upon the patient's clinical presentation:
(i) Consultation with a specialist in the area of the body affected by the pain;
(ii) Consultation with a pain management specialist;
(iii) A medication therapy management review by a pharmacist; or
(iv) Consultation with a specialist in addiction medicine or addiction psychiatry, if aberrant

behaviors indicating medication misuse or substance use disorder are noted.
(6) One hundred twenty MED. The advanced practice registered nurse shall not prescribe a dosage
that exceeds an average of one hundred twenty MED per day. This prohibition shall not apply under
the following circumstances:
(a) The advanced practice registered nurse holds national certification by a national certifying
organization approved according to section 4723.46 of the Revised Code in:
(i) Pain management;
(ii) Hospice and palliative care;
(iii) Oncology; or
(iv) Hematology, or coursework in hematology leading to certification in oncology;
Page 12
(b) The advanced practice registered nurse of has received a written recommendation for a dosage
exceeding an average of one hundred twenty MED per day from a board certified pain medicine
physician, a board certified hospice and palliative care physician, or a board certified oncology or
hematology physician, who based the recommendation on a face-to-face visit and examination of the
patient. The advanced practice registered nurse shall maintain the written recommendation in the
patient's record; or
(c) The patient was receiving an average daily dose of one hundred twenty MED or more prior to the
effective date of this rule. However, prior to escalating the patient's dose, the advanced practice
registered nurse shall receive a written recommendation as set forth in paragraph (J)(6)(b) of this
rule.
(7) The requirements of paragraph (J) of this rule do not apply when an opioid analgesic is
prescribed:
(a) To a patient in hospice care;
(b) To an patient who has terminal cancer or another terminal condition, as defined as follows:
An irreversible, incurable, and untreatable condition caused by disease, illness, or injury from which,
to a reasonable degree of medical certainty as determined in accordance with reasonable medical
standards by a physician who has examined the patient, both of the following apply:
(i) There can be no recovery; and
(ii) Death is likely to occur within a relatively short time if life-sustaining treatment is not
administered; or
(c) As an inpatient prescription as defined in rules adopted by agency 4729 of the Administrative
Code.
(K) As specified in section 4723.44 of the Revised Code, an advanced practice registered nurse
designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall
Page 13
not prescribe any drug or device to perform or induce an abortion, as that term is defined in section
(L) As specified in section 4723.488 of the Revised Code, notwithstanding the requirements of this
rule, an advanced practice registered nurse with a current valid license issued by the board and
designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may
prescribe or personally furnish naloxone.
(M) The requirements of paragraph (C)(9)(c) of this rule apply to prescriptions for products that
contain gabapentin.
(N) The advanced practice registered nurse may enter consult agreements with pharmacists in
accordance with section 4729.39 of the Revised Code and rules 4723-8-12 and 4723-8-13 of the
Administrative Code.
Page 14
Ohio Administrative Code
Rule 4730-2-07 Standards for prescribing.
Effective: February 28, 2023
(A) A physician assistant who holds a prescriber number and who has been granted physician-
delegated prescriptive authority by a supervising physician may prescribe a drug or therapeutic
device provided the prescription is in accordance with all of the following:
(1) The extent and conditions of the physician-delegated prescriptive authority, granted by the
supervising physician who is supervising the physician assistant in the exercise of the authority;
(2) The requirements of Chapter 4730. of the Revised Code;
(3) The requirements of Chapters 4730-1, 4730-2, 4730-4, 4731-11, 4731-35, and 4731-37 of the
Administrative Code; and
(4) The requirements of state and federal law pertaining to the prescription of drugs and therapeutic
devices.
(B) A physician assistant who holds a prescriber number who has been granted physician-delegated
prescriptive authority by a supervising physician shall prescribe in a valid prescriber-patient
relationship. This includes, but is not limited to:
(1) Obtaining a thorough history of the patient;
(2) Conducting a physical examination of the patient;
(3) Rendering or confirming a diagnosis;
(4) Prescribing medication, ruling out the existence of any recognized contraindications;
(5) Consulting with the supervising physician when necessary; and
Page 1
(6) Properly documenting these steps in the patient's medical record.
(C) The physician assistant's prescriptive authority shall not exceed the prescriptive authority of the
supervising physician under whose supervision the prescription is being written, including but not
limited to, any restrictions imposed on the physician's practice by action of the United States drug
enforcement administration or the state medical board of Ohio.
(D) A physician assistant holding a prescriber number and who has been granted physician-
delegated prescriptive authority by a supervising physician to prescribe controlled substances shall
apply for and obtain the United States drug enforcement administration registration prior to
prescribing any controlled substances.
(E) A physician assistant holding prescriber number and who has been granted physician-delegated
prescriptive authority by a supervising physician shall not prescribe any drug or device to perform
or induce an abortion.
(F) A physician assistant holding prescriber number and who has been granted physician-delegated
prescriptive authority by a supervising physician shall include on each prescription the physician
assistant's license number, and, where applicable, shall include the physician assistant's DEA
number.
Page 2
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Exhibit 7
Exhibit 8
Preterm-Cleveland v. Yost, --- N.E.3d ---- (2023)
2023 WL 8663888, 2023-Ohio-4570
The Chandra Law Firm, L.L.C., Subodh Chandra, and

2023 WL 8663888
Donald Screen; Cleveland, and Democracy Forward
Foundation, Skye L. Perryman, and Madeline H. Gitomer,
PRELIMINARY COPY, SUBJECT TO FURTHER
urging affirmance for amici curiae American College
EDITING
Supreme Court of Ohio. of Obstetricians and Gynecologists, American Medical
Association, and Society for Maternal-Fetal Medicine.
PRETERM-CLEVELAND et al., Appellees,
American College of Obstetricians and Gynecologists and
v.
Molly A. Meegan, urging affirmance for amicus curiae
YOST, Atty. Gen., et al., Appellants.
American College of Obstetricians and Gynecologists.
No. 2023-0004
Covington & Burling, L.L.P., Jacob Zuberi, Suzan Charlton,
|
Samar Amidi, and Kathryn Irwin Bronstein, in support of
Submitted December 12, 2023
appellees, for amicus curiae National Association of Social
|
Workers Including its Ohio Chapter.
Decided December 15, 2023
Scott G. Stewart, Mississippi Solicitor General, and Justin
APPEAL from the Court of Appeals for Hamilton County, L. Matheny, Deputy Solicitor General, urging reversal
No. C-220504, 2022-Ohio-4540. for amici curiae Mississippi, Alabama, Arkansas, Florida,
Attorneys and Law Firms Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Missouri
Montana, Nebraska, South Carolina, South Dakota, Texas,
ACLU of Ohio Foundation, B. Jessie Hill, Cleveland, Freda Utah, and West Virginia.
J. Levenson, and Rebecca Kendis; Wilmer Cutler Pickering
Alliance Defending Freedom, Julia C. Payne, and James A.
Hale & Dorr, L.L.P., Alan E. Schoenfeld, Michelle Nicole
Campbell, urging reversal for amici curiae Cincinnati Right
Diamond, Peter Neiman, Davina Pujari, Christopher A.
to Life, The Justice Foundation, Center for Christian Virtue,
Rheinheimer, and Allyson Slater; and Planned Parenthood
Ohio Right to Life, Right to Life Action Coalition, Cleveland
Federation of America and Melissa Cohen, for appellees
Right to Life, Greater Columbus Right to Life, and Students
Planned Parenthood Southwest Ohio Region, Sharon Liner,
for Life of America.
M.D., and Planned Parenthood of Greater Ohio.
Dworken & Bernstein Co., L.P.A., and Patrick J. Perotti,
ACLU of Ohio Foundation, B. Jessie Hill, Cleveland,
Painesville, urging reversal for amicus curiae American
Freda J. Levenson, and Rebecca Kendis; and American
Center for Law & Justice.
Civil Liberties Union Foundation and Meagan Burrows,
for appellees Preterm Cleveland, Women's Med Group Corey Shankleton, pro se, in support of appellant, for amicus
Professional Corporation, and Northeast Ohio Women's curiae Faith2Action Michigan.
Center, L.L.C., d/b/a Toledo Women's Center.
Janet Folger Porter, pro se, in support of appellant, for amicus
John A. Borell, Kevin A. Pituch, and Evy M. Jarrett, Lucas curiae Faith2Action Ministries.
County Assistant Prosecuting Attorneys, for appellee Lucas
County Prosecuting Attorney Julia R. Bates. Andrew L. Schlafly; and Robert T. Lynch, in support of
appellant, for amici curiae Phyllis Schlafly Eagles, Janet
Dave Yost, Ohio Attorney General, Michael J. Hendershot, Folger Porter, Faith2Action Ministries, Ohio Representative
Chief Deputy Solicitor General, Stephen P. Carney and Beth Lear, Ohio Value Voters, Mission America, Margie
Mathura J. Sridharan, Deputy Solicitors General, and Christie, Dayton Right to Life Society, Ohio Christian
Amanda L. Narog and Andrew D. McCartney, Assistant Alliance, Warren County Right to Life, Lori Viars, Eagle
Attorneys General, for appellants. Forum of Ohio, Community Pregnancy Center, former Ohio
Representative Candice Keller, former Ohio Representative
Tucker Ellis, L.L.P., Susan M. Audey, Elisabeth C. Arko, and
Ron Hood, and Eagle Forum Education & Legal Defense
Edward E. Taber, Cleveland, urging affirmance for amicus
Fund.
curiae Academy of Medicine of Cleveland & Northern Ohio.
© 2024 Thomson Reuters. No claim to original U.S. Government Works. 1

Preterm-Cleveland v. Yost, --- N.E.3d ---- (2023)
2023 WL 8663888, 2023-Ohio-4570
Opinion
Byrne, J., dissents and would proceed with addressing the
*1 {¶ 1} Sua sponte, appeal dismissed due to a change in propositions of law previously accepted for review.
the law.
Matthew Byrne, J., of the Twelfth District Court of Appeals,
sitting for Deters, J.
Kennedy, C.J., and Fischer, DeWine, Donnelly, and Stewart, All Citations
JJ., concur.
--- N.E.3d ----, 2023 WL 8663888 (Mem), 2023-Ohio-4570
Brunner, J., dissents and would dismiss the appeal as having
been improvidently accepted.
End of Document © 2024 Thomson Reuters. No claim to original U.S. Government Works.
© 2024 Thomson Reuters. No claim to original U.S. Government Works. 2

Attorneys challenge Ohio abortion laws

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Attorneys challenge Ohio abortion laws

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IN THE COURT OF COMMON PLEAS

HAMILTON COUNTY, OHIO

constitutional amendment (the “Amendment”), effective as of December 7, 2023, as Article I,

of their education, training, and experience, R.C. 2317.56(B), 2919.123, 4723.44(B)(6),

4723.50(B)(1), 4723.151(C), 4730.02(E), 4730.03(F), 4730.39(B)(2), 4730.42(A)(1); Ohio

prejudice to Defendants, leave to amend should be granted.

determining the constitutionality of abortion restrictions. Allowing Plaintiffs to amend their

restraining order followed by a preliminary injunction, a declaratory judgment, and permanent

injunctive relief, against the Telemedicine Ban.

psychological, and emotional well-being. That preliminary injunction is still in effect.

II. LAW AND ANALYSIS

to Defendants, and thus should be granted in the interest of justice.

purposes. See R.C. 2317.56(B), 2919.11, 2919.123, 4723.44(B)(6), 4723.50(B)(1), 4723.151(C),

4730.02(E), 4730.03(F), 4730.39(B)(2), 4730.42(A)(1); Ohio Adm.Code 4723-9-10(K), 4730-2-

State, risking harm to Ohioans’ health and well-being.

in pregnancy up to which medication abortion can be provided according to evidence-based

new claim under Article I, Section 22.

sufficient time to prepare).

“merely a question of law”).

amend the Complaint be granted.

A proposed order will be filed separately.

/s/__Michelle Nicole Diamond______ B. Jessie Hill (0074770)

Counsel for Plaintiffs

*Motion for pro hac vice forthcoming

Dated: May 9, 2024

OHIO DEPARTMENT OF HEALTH

BRUCE T. VANDERHOFF, M.D., MBA

KIM G. ROTHERMEL, M.D.

HARISH KAKARALA, M.D.

ERIN KEELS, DNP, APRN-CNP

CANDY SUE RINEHART, DNP, APRN-CNP

MATHIAS H. HECK, JR.

SHARON LINER, M.D.

PLANNED PARENTHOOD OF Judge Alison Hatheway

WOMEN’S MED GROUP

BRUCE T. VANDERHOFF, M.D., MBA

KIM G. ROTHERMEL, M.D.

HARISH KAKARALA, M.D.

ERIN KEELS, DNP, APRN-CNP

CANDY SUE RINEHART, DNP, APRN-

MATHIAS H. HECK, JR.

1. On November 7, 2023, Ohioans voted to amend the Ohio Constitution to protect an

limited to decisions on . . . abortion.” Ohio Constitution, Article I, Section 22(A) (the

S. Ct. 2228, 213 L.Ed.2d 545 (2022).1

Challenged Laws impose on medication abortion access.

3. Moreover, the Challenged Laws do nothing to advance patient health in accordance

4. The Telemedicine Ban prohibits abortion providers from providing medication

harm to Ohioans’ health and well-being.

4723.50(B)(1), 4723.151(C), 4730.02(E), 4730.03(F), 4730.39(B)(2), 4730.42(A)(1); Ohio

Adm.Code 4723-9-10(K), 4730-2-07(E). Abortion providers and APCs, including physician

difficult choice: seek a procedural abortion, which may be contraindicated, traumatizing, or

unwanted pregnancy to term.

judgment that the Challenged Laws violate the Ohio Constitution.

8. Planned Parenthood Southwest Ohio Region (“PPSWO”) is a nonprofit

9. Sharon Liner, M.D., is a physician licensed to practice medicine in Ohio. Dr.

10. Julia Quinn, MSN, WHNP-BC, is a board-certified NP, a type of APRN, at

including, for example, prescribing contraception, inserting and removing long-acting

behalf of herself and her patients.

11. Planned Parenthood of Greater Ohio (“PPGOH”) is a nonprofit corporation

12. Women’s Med Group Professional Corporation (“WMGPC”) owns and

APCs, staff, officers, and agents; and its patients.

13. Preterm-Cleveland (“Preterm”) is a nonprofit clinic in Cleveland, Ohio, which has

prescribe mifepristone according to evidence-based standards and as clinically indicated, including

83-05, -05.1, -.05.2, -09(A), -03(D).

/s/Michelle Nicole Diamond____ B. Jessie Hill (0074770)